Comparative study of fetomaternal outcome using new screening criteria of serum TSH for diagnosing hypothyroidism in pregnancy

Abstract

Objectives: To assess the maternal and fetal outcomes using new screening criteria with upper serum thyroid stimulating hormone (TSH) cut off as >3mIU/L, for diagnosing hypothyroidism in pregnancy. Materials and Methods: This study was a cross sectional study, carried out in the department of Obstetrics and Gynaecology. During one year of study period from February 2016 to January 2017, pregnant women with ≤ 20 weeks gestation, attending antenatal OPD were included in the study and they were followed till delivery. On the basis of serum TSH level, women were divided into study group with serum TSH level between 3.1 to 6 mIU/L, (new range to be studied) and an equal number of ages and parity matched control group with serum TSH levels between 0.4 to 3 mIU/L. The maternal and fetal outcomes were compared between study and control groups. Results: During the study period, in study group 96 women had serum TSH between 3.1-6 mIU/L. Maternal and fetal outcomes in both the groups were comparable. Study did not find any difference in the rate of spontaneous abortion between women in study and control group [p > 0.99]. There was no significant difference in the maternal complications like preeclampsia, gestational diabetes and placental abruption in the study and control group. Vaginal delivery and caesarean section were similar in both the groups. Study shows no significant difference of foetal outcome in study and control group [p > 0.05]. Conclusion: As compared to pregnant women with serum TSH levels <3mIU/L, women with serum TSH levels between 3.1-6.0mIU/L had no significant adverse fetomaternal outcome.

Screening of Subclinical Hypothyroidism in Antenatal Women and its Impact on Pregnancy Outcomes

“…The miscarriage rate in the study and control group was the same (p=0.1146). Similar findings were observed by Hiriyur et al, 17 and Joshi et al 18 As thyroid hormones have many effects on cardio-vascular physiology and blood pressure regulation, there is a high prevalence of gestational hypertension in hypothyroid women compared to euthyroid women. We observed 53 (33.125%) cases of pre-eclampsia in the study group compared to 13 (8.125%) cases in the control group.…”

“…Roy et al, also observed a high cesarean section rate in hypothyroid women and an increased rate of spontaneous vaginal delivery in euthyroid women. 1 Nevertheless, Hiriyur et al, 17 and Joshi et al, 18 found a similar cesarean section rate in both cases and control. A study done in Agha Khan showed that ladies with preconception TSH >2.5 µIU /ml had significantly high cesarean section rate.…”

“…15 We observed that 41 (25.6%) cases had a preterm delivery, and 10 (6.25%) controls had preterm delivery. However, Hiriyur et al, 17 observed no significant difference in the number of preterm deliveries in hypothyroid and euthyroid women.…”

“…A similar finding was observed by studies done in China, 7 and India. 1 However, Hiriyur et al, 17 and Dima Ezzeddine, 15 observed no statical difference in preeclampsia in cases and controls.…”