‘’Study of thyroid level in Indian pregnant women’s’’

Abstract

Introduction- Thyroid dysfunction is a common disorder in pregnancy which affects both maternal and fetal outcomes.
There are very less and limited data on prevalence of hypothyroidism during pregnancy from India because no such big
study done till now. this study done to define cut off value of serum TSH level in Indian pregnant women as hypothyroid
and maternal and fetal outcomes. This study was planned to establish a lower cut off value for serum TSH to diagnose
hypothyroidism in Indian pregnant women. Material and Methods - This is a prospective and retrospective cohort study conducted in a period of 1.5 years between September 2021 to April 2023, in the department of Obstetrics & Gynecology GMC Shahdol in 1000 pregnant women’s who comes in antenatal checkup in opd. All healthy pregnant women with singleton pregnancy willing to participate in the study were enrolled. Women which have multiple pregnancy, known chronic medical disorder like diabetes, hypertension, any autoimmune disorder with hyperthyroidism or known hypothyroidism, bad obstetric history with a known cause are
excluded from study. However, there are few limitations of this study. We have not assessed trimester specific ranges. Follow up beyond newborn period was not possible because after discharge most infants either did not come for follow up or they were seen in pediatric clinic. We did not carry out thyroid examination using ultrasound, and we have not evaluated other causes of
hypothyroidism in these women. All pregnant women underwent ELISA TSH assay. Women with serum TSH >6.2mIU/L underwent Free Thyroxin (FT4) estimation and labelled as overt hypothyroid (OH) (group I) or subclinical hypothyroid (SCH) (group II). Women with
serum TSH between 3-6.2mIU/L & 0.4-3mIU/L were labelled as group III & control. Foeto-maternal outcomes were compared between group I,II,III & controls
Result - The prevalence of SCH & OH was 6.4% and 3.8%. Pre-eclampsia, gestational DM & IUFD in group I and foetal distress in group II developed in significantly higher number of women (p=0.009, p=0.002, p=0.002 & p=0.004 respectively) Foeto-maternal variables assessed in group III none was significantly different from control group