Assessment of Thyroid Dysfunction Among Pregnant Women With Pre-Existing Diabetes Mellitus or Gestational Diabetes Mellitus

Abstract

Objective This study investigates the prevalence and risk of thyroid disturbances in pregnant women with pre-existing diabetes mellitus (DM) or gestational diabetes mellitus (GDM) in a tertiary hospital setting in Riyadh, SA. This research's findings may help identify potential risk factors associated with thyroid disturbances during pregnancy and facilitate early diagnosis for at-risk pregnant women. Subjects and methods A retrospective cross-sectional study was conducted at an endocrinology clinic between October 2018 and December 2021 to evaluate the electronic records of pregnant women with DM or GDM who had documented normal thyroid function before pregnancy. Results Three hundred ninety-six files that met the selection criteria were deeply investigated and analyzed. The analysis showed that 378 (95.5%) patients were of Saudi nationality, and the mean age in years ± SD for the selected patients was 34.23 ± 5.468. The prevalence of obesity was 63.7%, with a mean body mass index (BMI) of 32.78 ± 6.78 kg/m2. The patients in this study were categorized into three groups based on their type of DM: 57 were diagnosed with type 1 DM (14.4%), 120 with type 2 DM (30.3%), and 219 with GDM (55.3%). The study identified 43 patients (10.85%) with subclinical hypothyroidism and 74 (18.69%) with hypothyroidism. Among the remaining patients, thyroid function was within the normal range for 264 (66.67%). The study also identified eight patients (2.02%) with subclinical hyperthyroidism and seven (1.77%) with hyperthyroidism. The prevalence of thyroid dysfunction was reported at 33.4%, with most of the dysfunction observed in the GDM group (20.7%). By comparison, the type 1 DM and type 2 DM groups presented a lower prevalence of thyroid dysfunction, accounting for only 4.1% and 8.6%, respectively. Conclusions Hypothyroidism, both clinical and subclinical, is more prevalent among patients with GDM than individuals with type 1 and type 2 DM. Research suggests a greater risk of developing hypothyroidism in patients with an increased BMI and among those older during pregnancy.

Associated factors of depression in primiparas with hypothyroidism during pregnancy

“…[2] Common signs include retarded speech, pale, dry and inelastic skin, non-pitted edema of the skin, sparse hair, dry and dull, and diffuse or nodular growth of the thyroid gland. [2] During pregnancy, these functions can indirectly affect the development of the embryo and the fetus due to insufficient thyroid in the blood, affecting the fetal brain and intellectual development leading to dementia, and also have a greater impact on the growth and development of the old and long bones after birth. [2] The results of the present study on primiparas with hypothyroidism during pregnancy in our hospital showed that of the 200 pregnant women participating in the study, 27 were suffering from depression with self-rating depression scale >50, and the incidence of depression was 13.50%.…”

“…[2] During pregnancy, these functions can indirectly affect the development of the embryo and the fetus due to insufficient thyroid in the blood, affecting the fetal brain and intellectual development leading to dementia, and also have a greater impact on the growth and development of the old and long bones after birth. [2] The results of the present study on primiparas with hypothyroidism during pregnancy in our hospital showed that of the 200 pregnant women participating in the study, 27 were suffering from depression with self-rating depression scale >50, and the incidence of depression was 13.50%. There were differences in age, education level, economic income, sleep quality, and conjugal relations between the depressed and nondepressed primiparas.…”

“…During pregnancy, relative hypothyroidism may occur due to a temporary increase in the body's need for the thyroid gland, resulting in hypothyroidism during pregnancy. [2] Pregnant women are afraid of cold, fatigue, weakness, weakness, lethargy, apathy, slow reaction to emotional depression, hair loss, dry skin, less sweating, although poor appetite but weight still increased, muscle stiffness pain can appear in fingers and hands with pain and burning sensation or needle like abnormal feeling. [2] According to the etiology, hypothyroidism can be divided into 3 categories: secondary hypothyroidism, peripheral hypothyroidism, and primary hypothyroidism.…”

“…[2] Pregnant women are afraid of cold, fatigue, weakness, weakness, lethargy, apathy, slow reaction to emotional depression, hair loss, dry skin, less sweating, although poor appetite but weight still increased, muscle stiffness pain can appear in fingers and hands with pain and burning sensation or needle like abnormal feeling. [2] According to the etiology, hypothyroidism can be divided into 3 categories: secondary hypothyroidism, peripheral hypothyroidism, and primary hypothyroidism. Its main clinical manifestations include indifferent expressions, a pale complexion, dry, thickened, rough skin, and swelling in the cheeks and around the eyes, which seriously affects the patient's quality of life.…”

“…Particularly prevalent among pregnant women, there are clear changes in thyroid function, eventually forming hypothyroidism. [ 1 , 2 ] Hypothyroidism is a common clinical disease that mostly affects women of childbearing age. During pregnancy, relative hypothyroidism may occur due to a temporary increase in the body’s need for the thyroid gland, resulting in hypothyroidism during pregnancy.…”