Aim Subclinical hypothyroidism is thought to be associated with adverse pregnancy outcomes but the data is conflicting and generally depends on antibody positivity and treatment. We evaluated the pregnancy outcomes in Turkish population with untreated, antibody negative subclinical hypothyroidism for the first time. Methods We searched for 30 015 patients between January 2016 and May 2017 retrospectively. Finally, a total of 930 pregnant women with untreated, antibody negative subclinical hypothyroidism and 7986 controls were included. Demographic characteristics, laboratory findings and pregnancy outcomes, including pregnancy loss, impaired glucose tolerance, gestational diabetes, hypertensive disorders of pregnancy, preterm birth, neonatal intensive care unit admission, placenta previa and abruption, cesarean delivery, low birthweight, Apgar score <7 and premature rupture of membranes were recorded. Results Demographic and laboratory characteristics were similar between two groups except thyroid stimulating hormone levels and previous uterine surgery rates. Subclinical hypothyroidism group had an increased risk of pregnancy loss (odds ratio [OR] 2.583; 95% confidence interval [CI] 1.982–3.365; P < 0.001), impaired glucose tolerance (OR 1.952; 95% CI 1.450–2.627; P < 0.001), hypertensive disorders of pregnancy (OR 1.476; 95% CI 1.113–1.923; P = 0.004), neonatal intensive care unit admission (OR 1.620; 95% CI 1.084–2.420; P = 0.019), placenta previa (OR 12.581; 95% CI 5.046–31.363; P < 0.001) and cesarean delivery (OR 1.263; 95% CI 1.091–1.462; P = 0.002). Conclusion Subclinical hypothyroidism has worse pregnancy outcomes as compared to euthyroid pregnant women even in antibody negativity. Therefore, we suggest that all pregnant women should routinely be screened in their first antenatal visits for thyroid functions.

Objective:The relationship between hemoglobin levels and pregnancy outcomes is still a challenging issue. There is a supported opinion about the increased adverse pregnancy outcomes both with low and high hemoglobin levels. In this study, we aimed to evaluate this association for first trimester hemoglobin levels in a Turkish population.Materials and Methods:In this retrospective study, 1306 women who were followed up during their pregnancy and gave birth in our clinic were enrolled. The patients were divided into three groups: hemoglobin <11 g/dL (n=490), 11≤ hemoglobin <13 g/dL (n=673), and hemoglobin ≥13 g/dL (n=143). The hemoglobin <11 g/dL group was classified into two subgroups as hemoglobin ≤9 g/dL (n=64) and hemoglobin >9 g/dL (n=426). Demographic characteristics, first trimester hemoglobin levels, gestational age at delivery and mode, birth weight, Apgar scores, and pregnancy outcomes were recorded and compared between the groups.Results:Pregnancy-induced hypertension, preterm birth, neonatal intensive care unit admission, birth weight, gestational age at delivery, Apgar scores, and postpartum hemorrhage were significantly different between the three groups. In the pairwise comparison, gestational age at delivery, birth weight, and first minute Apgar scores were higher in the 11≤ hemoglobin <13 g/dL group, and pregnancy-induced hypertension was more common in the hemoglobin ≥13 g/dL group as compared with the others. Moreover, the preterm delivery rate was highest in the hemoglobin ≥13 g/dL (26.6%) group and lowest (7.3%) in the 11≤ hemoglobin <13 g/dL group. The neonatal intensive care unit admission rate was higher both the hemoglobin <11 g/dL and hemoglobin ≥13 g/dL groups. Postpartum hemorrhage was more common in the hemoglobin <11 g/dL group as compared with the other groups. Furthermore, pregnancy-induced hypertension was more common in the hemoglobin ≤9 g/dL subgroup (p=0.012).Conclusion:In conclusion, both low and high hemoglobin levels are related with adverse pregnancy outcomes. We suggest that hemoglobin levels must be screened during pregnancy to provide maternal and fetal well-being.

No abstract

In clinical practice, chronic hypertensive pregnants are generally followed up in their future life for cardiovascular disorders. Also, we recommend that we must inform and follow preeclamptic patients for future cardiovascular diseases.