Gestational Diabetes Mellitus with autoimmune subclinical hypothyroidism in pregnancy in relation to gravida.

INTRODUCTION

Gestational diabetes mellitus (GDM) and hypothyroidism are the most common endocrinological abnormalities associated with pregnancy. The association of gravida with incidence of autoimmune subclinical hypothyroidism (SCH) and GDM in pregnancy has not been studied extensively with availability of very limited data in this context. So, this study was done to find out the association between GDM and autoimmune SCH in pregnancy as per gravida status of the study population.

MATERIALS AND METHODS

382 antenatal cases, both primi and multigravida, were screened for thyroid dysfunction and GDM in their first ANC coming to a tertiary level health care institution. 75 gm GCT was used for diagnosis of GDM and serum TSH, fT4, and anti-TPO antibody were measured for assessment of thyroid dysfunction. Prevalence of SCH was evaluated taking the ATA 2011 guidelines. Data obtained was also compared with ATA 2017 recommendations. Anti-TPO antibody level more than 60 U/L was considered to be raised value.

OBSERVATION

The percentage of GDM was higher in autoimmune SCH participants compared to euthyroid cases with raised anti-TPO Ab Titer. GDM, SCH, and raised anti-TPO Ab titer were overall more prevalent in multigravida cases compared to primigravida participants.

CONCLUSION

GDM and SCH with high anti-TPO Ab titer were more prevalent in multigravida participants compared to primigravida cases though not statistically significant. As occurrence of SCH varies with nutritional and geographical factors, hence internal trimester specific range should be calculated and used in practice as recommended by ATA 2017 guidelines.