Feto-maternal Outcome Using New Screening Criteria of Serum TSH for Diagnosing Hypothyroidism in Pregnancy

Joshi, Deeksha; Dewan, Rupali; Bharti, Rekha; Thariani, Karishma; Sablok, Aanchal; Sharma, Mukut; Biswas, Krishna; Batra, Aruna

doi:10.7860/jcdr/2015/11106.5735

Cited by 10 publications

(11 citation statements)

References 22 publications

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“…GH ( p -value 0.4) and pre-eclampsia (p-value 0.19) were not significantly associated in our patients with preconception TSH > 2.5 uIU/mL. This is similar to a case-control study conducted in India, where gestational hypertension and pre-eclampsia were not associated with hypothyroidism, although their TSH cutoff was between 3.1–6.2 uIU/mL [50] and a population-based prospective data from Finland also reports no significant association [subclinical hypothyroidism 20/213 (9.4%), p-value 0.615, HR 1.1 (0.7–1.7), Adjusted HR 1.0 (0.7–1.6)] [44]. In our study, postpartum hemorrhage was significantly associated with hypothyroidism (p-value 0.01 in preconception and 0.03 in 3rd trimester), however, this is less well reported in the literature [32, 51] and need multiple prospective case-control studies in our setup.…”

Section: Discussionsupporting

confidence: 81%

Maternal characteristics and outcomes affected by hypothyroidism during pregnancy (maternal hypothyroidism on pregnancy outcomes, MHPO-1)

Kiran

Sheikh

Malik³

et al. 2019

BMC Pregnancy Childbirth

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Background: Hypothyroidism in pregnancy is an arena of ongoing research, with international conflicts regarding screening, management, and outcomes. Various studies have described the outcomes depending on geographical and international diagnostic criteria. No study has been conducted in this regard from the region of Pakistan. Therefore, we aim to report the clinical features and maternal outcomes of hypothyroid pregnancies and compare the maternal outcomes between uncontrolled and controlled TSH levels in the preconception as well as the gestational period. Methods: We conducted a cross-sectional retrospective study on 718 cases in the Aga Khan University Hospital after ethical approval. We collected information on pregnant females who have diagnosed hypothyroidism before conception or during their antenatal period. We noted the maternal characteristics and maternal comorbidities. Laboratory data were recorded for thyroid stimulating hormone levels before conception and during gestation. We recorded maternal outcomes as pregnancy loss (including miscarriage, stillbirth/intrauterine death, medical termination of pregnancy and ectopic pregnancy), gestational hypertension, pre-eclampsia, postpartum hemorrhage, placental abruption, and modalities of delivery. Data analysis was performed on Statistical Package for the Social Sciences version 20.0. Results: Among 708 hypothyroid women 638 had live births. Postpartum hemorrhage was the most frequent maternal outcome (38.8%). The emergency cesarean section occurred in 23.4% of cases. We determined TSH levels in 53.2, 56.7, 61.7 and 66.6% of cases in preconception, 1st, 2nd, and 3rd trimester periods. A significant association existed between cesarean section and preconception thyrotropin levels > 2.5 mIU/L, whereas postpartum hemorrhage was significantly associated with thyrotropin levels > 2.5 mIU/L in the preconception and third trimester. Conclusion: Successful live births in our patients were complicated by maternal postpartum hemorrhage and a frequent number of emergency cesarean section.

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Section: Discussionsupporting

confidence: 81%

Maternal characteristics and outcomes affected by hypothyroidism during pregnancy (maternal hypothyroidism on pregnancy outcomes, MHPO-1)

Kiran

Sheikh

Malik³

et al. 2019

BMC Pregnancy Childbirth

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“…Sahu et al, reported higher number of caesarean section for fetal distress 14 . Rates of caesarian section for fetal distress in study and control group were similar in study by Deeksha et al 10 . In our study the rates of vaginal delivery and caesarean section were similar in both the groups [ Table 3].…”

Section: Discussionsupporting

confidence: 78%

“…High incidence of gestational diabetes mellitus (GDM) in hypothyroid women was reported by Sarojamma et al but study was not case controlled 5 . Deeksha et al did not find any association between GDM and subclinical hypothyroidism (SCH) 10 . In our study maternal complications like preeclampsia, gestational diabetes and placental abruption were similar in the study and control group [ Table 1].…”

Section: Discussionmentioning

confidence: 96%

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

Chidanandaiah¹,

Tharihalli²,

Gaddi³

2019

OBGYN

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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.

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“…Joshi et al and Saraladevi et al had observed similar findings with respect to neonatal outcomes, but Ajmani et al and Nazarpour S et al didn't report hyperbilirubinemia as a major occurrence. [7][8][9]11…”

Section: Discussionmentioning

confidence: 99%

“…4 Anemia, preeclampsia, prematurity, fetal loss and fetal growth restriction, low birth weight and neonatal hyperbilirubinemia are the usually reported complications of thyroid dysfunction. [5][6][7] Only few Indian studies have dwelled into the effect of thyroid status over various complications during maternal/perinatal period. With the prevailing research gap in mind, the present study was planned with the objective of analysis the relationship of maternal thyroid status in pregnancy and various maternal and fetal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Study of implications of thyroid status over feto-maternal outcomes in pregnancy

Gedam

Bhushan

2020

Int J Reprod Contracept Obstet Gynecol

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Background: Thyroid disorders are reported at clinically significant prevalence during pregnancy, affecting ~5% of all pregnancies. Maternal thyroid status during pregnancy purportedly affects fetal as well as maternal outcomes. The objective of present study was to analyse the relationship of thyroid status in pregnancy and various maternal and fetal outcomes.Methods: In this hospital based observational study, a total of 913 pregnant women were enrolled as per fixed criteria and all the study participants were screened for thyroid disorders. Further, they were followed up throughout pregnancy and puerperium and evaluated for various maternal and fetal complications by predefined outcome measures. The results were compared by subgroup analysis.Results: Of the 913 patients screened, 105 were diagnosed with thyroid abnormality and followed up till delivery, with newborn thyroid profile on day 7. Total 49 patients were diagnosed with anaemia (46.66%), of which 46 (43.80%) had subclinical hypothyroidism (p <0.05); along with pregnancy induced hypertension in 42 (40%) cases of which 40 (38.09%) had subclinical hypothyroidism were observed to have statistically significant associations. Intrauterine growth restriction (IUGR) (37, 35.23%) and prematurity (19, 18.1%) were the most common fetal occurrences; the association of IUGR and subclinical hypothyroidism being statically significant.Conclusions: Thyroid disorders during pregnancy are commonly associated with maternal and fetal complications and thyroid profile is recommended as universal screening method in early pregnancy to diagnose and start required treatment early.

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Feto-maternal Outcome Using New Screening Criteria of Serum TSH for Diagnosing Hypothyroidism in Pregnancy

Cited by 10 publications

References 22 publications

Maternal characteristics and outcomes affected by hypothyroidism during pregnancy (maternal hypothyroidism on pregnancy outcomes, MHPO-1)

Maternal characteristics and outcomes affected by hypothyroidism during pregnancy (maternal hypothyroidism on pregnancy outcomes, MHPO-1)

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

Study of implications of thyroid status over feto-maternal outcomes in pregnancy

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