Introduction The impact of thyroid autoimmunity in pregnancy on neonatal outcomes remains unclear. Studies to date have revealed a positive correlation between thyroid antibodies and preterm births and miscarriages. However other aspects of neonatal outcomes need further exploration. Advanced maternal age is associated with the escalation of the prevalence of thyroid antibodies. Not only this, advanced maternal age in itself is a proven factor for unfavourable fetal outcomes. Most of the studies to date in this regard have an age-related bias as women of all groups were included to assess the neonatal outcomes in women with thyroid antibodies. Our study was conducted in hypothyroid women who were less than 35 years of age with thyroid antibodies to assess outcomes on the neonates unbiased of advanced maternal age. Hypothesis To evaluate the effects of maternal thyroid autoimmunity on neonatal outcomes. Methodology A retrospective chart review was conducted on 7978 women delivered in the study timeline in a secondary hospital of Qatar. 287 women were hypothyroid and out of these 198 women with age less than 35 years were included in the study. Neonatal outcomes such as preterm births, small for date babies, admission to neonatal intensive care units (NICU) and intrauterine fetal deaths (IUFD) were noted and compared with 200 euthyroid women who were selected by random sampling. Statistical Package for the Social Sciences version 27. 0 was used for statistical analysis. The Odds’ ratio was calculated and results with a value of p<0. 05 was considered significant. Results Thyroid autoimmunity was noted in 30.30% of hypothyroid pregnant women. All these women had thyroid peroxidase antibody and thyroglobulin antibody was observed in 4.44%. The range of TPO antibodies was 67-1350 IU/ml (mean 497 IU/ml). 10% vs 4.5% (OR- 2.22, 95%CI-0.760 to 6.495, P = 0.14) preterm births and 10% vs 3% (OR-3.33, 95%CI-1. 037-10.71, p<0. 05) small for dates babies were observed in women with thyroid antibodies in comparison to the control (euthyroid pregnant women). Higher incidence of NICU admissions (22% Vs 8.5%, p<0. 05) and IUFD rates (5% Vs 0.5%, p<0. 05) were noted in women with thyroid autoimmunity. Conclusion This study demonstrates the detrimental effects of thyroid autoimmunity on neonates of hypothyroid women less than 35 years of age. In this age group of hypothyroid women, testing for thyroid immunity should be considered. Antenatal fetal surveillance is advisable in the presence of thyroid antibodies. References: Roberto Negro, Alan Schwartz, Riccardo Gismondi, Andrea Tinelli, Tiziana Mangieri, Alex Stagnaro-Green, Thyroid Antibody Positivity in the First Trimester of Pregnancy Is Associated with Negative Pregnancy Outcomes, The Journal of Clinical Endocrinology & Metabolism, Volume 96, Issue 6, 1 June 2011, Pages E920–E924. Stagnaro-Green, A. et al. (2005). The thyroid and pregnancy: a novel risk factor for very preterm delivery. Thyroid,15(4), 351-357. Presentation: No date and time listed

Background and objective Among the common endocrinological disorders of pregnancy, thyroid disorders rank second after diabetes. Thyroid autoimmunity is linked to sub-fertility, miscarriages, preterm birth, gestational diabetes, and adverse neurodevelopmental sequelae in children. Peroxidase and thyroglobulin autoantibodies may be associated with enhanced global autoimmune state, which may have adverse effects on the fetal or placental development. It is the main cause of hypothyroidism in reproductive-age women and is associated with poor obstetric outcomes. In Gulf countries, a higher prevalence of thyroid antibodies during pregnancy was reported. However, there is paucity of data in the literature in the Gulf countries in this regard. Our study was conducted to assess the effects of thyroid antibodies on adverse maternal and neonatal outcomes in pregnancy in a multiethnic population of Qatar. The study aimed to assess the prevalence of thyroid antibodies in pregnant hypothyroid women and their impact on adverse fetal outcomes in pregnancy. Design A Retrospective study of patients' notes (retrospective chart review) was conducted at a secondary hospital in Qatar. Records of the women who delivered from January 2017 to June 2018 were evaluated. A total of 384 women were included after applying exclusion criteria. Neonatal outcomes were compared in hypothyroid women with (group A1) and without thyroid antibodies (group A2) and were compared with euthyroid women (group B). Statistical analysis was performed using SPSS Statistics version 27.0 (Armonk, NY: IBM Corp). Results A total of 7978 women delivered during the study period and the prevalence of hypothyroidism in our sample was 3.47%; 33.33% had thyroid antibodies. Women with more than one miscarriage were 30% (odds ratio {OR}: 2.06, 95% confidence interval {CI}: 1.112-3.811, p<0.05), 21.24% (OR: 1.20, 95% CI: 0.676-2.115, p>0.05), and 17% in group A1, A2, and B, respectively. The incidence of preterm births was 10% (OR: 2.22, 95% CI: 0.760-6.495, p>0.05), 4.23% (OR: 0.94, 95% CI: 0.308-2.876, p>0.05), and 4.5% in groups A1, A2, and B, respectively. Small for gestational age infants were 10% (OR: 3.33, 95% CI: 1.036-10.71, p<0.05), 5.93% (OR: 1.97, 95% CI: 0.640-6.023, p>0.05), and 3% in groups A1, A2, and B, respectively. The study revealed an association between thyroid antibodies and adverse maternal and neonatal outcomes in pregnancy. Conclusion Thyroid autoimmunity is associated with poor fetal outcomes. In Gulf countries with higher prevalence of endocrinological disorders (obesity and diabetes), thyroid disorders need attention. As fewer studies were reported from these areas with limited results in literature, this study gives an insight into the prevalence of thyroid disorders, thyroid antibodies, and their association with pregnancy outcomes.