Perinatal consequences of maternal hypothyroidism in early pregnancy and inadequate replacement

Wasserstrum, Nathan; Ca, Anania

doi:10.1111/j.1365-2265.1995.tb02642.x

Cited by 89 publications

(42 citation statements)

References 25 publications

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“…Women with hypothyroidism have decreased fertility (9), even if they conceive, the risk of miscarriage is increased (19). The risk of gestational hypertension, pre-eclampsia and eclampsia, abruption placentae, post partum haemorrhage, premature delivery and IUGR is increased (20, 21).…”

Section: Discussionmentioning

confidence: 99%

Thyroid autoimmunity and obstetric outcomes in women with recurrent miscarriage: a case–control study

Lata¹,

Dutta²,

Sivasubbu³

et al. 2013

Endocrine Connections

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ObjectivesThyroid antibody positivity during pregnancy has been associated with adverse outcomes including miscarriage and preterm delivery. The aim of the study is to evaluate the obstetric outcome in pregnant women with recurrent miscarriage and their response to levothyroxine (l-T4) therapy.Study design and methodsAll pregnant and non-pregnant women between 21 and 35 years of age with a history of two or more consecutive miscarriages were included in the study. A third group comprising 100 pregnant women without a history of miscarriage were taken as healthy controls. Thyroid autoimmunity, prevalence of subclinical hypothyroidism and maternal and foetal complications were analysed in all the groups with appropriate statistical methods.ResultsThe mean age of the patients included in the study was 27.0±3.1 years. Of 100 pregnant patients with previous recurrent miscarriage, thyroid autoimmunity (thyroid peroxidase antibody (TPOAb+) >34 U/ml) was found in 31% of the cases. The incidence of subclinical hypothyroidism was higher in TPOAb+ group than in TPOAb− group (52 vs 16%; P=0.0002). There was no difference in the prevalence of miscarriage or obstetric outcomes between recurrent miscarriage and healthy pregnant women group irrespective of TPO status.ConclusionsThe prevalence of thyroid autoimmunity was higher in pregnant women with a history of recurrent abortion compared with healthy pregnant control population. Following l-T4 treatment, there was no difference in prevalence of miscarriage between hypothyroid and euthyroid individuals in TPOAb+ women.

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Section: Discussionmentioning

confidence: 99%

Thyroid autoimmunity and obstetric outcomes in women with recurrent miscarriage: a case–control study

Lata¹,

Dutta²,

Sivasubbu³

et al. 2013

Endocrine Connections

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“…Several studies have reported that maternal hypothyroidism is associated with increased risks of abortions, stillbirths, preterm delivery, and pregnancy-induced hypertension [3–6]. Autoimmune thyroid disease is common in pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…Hypothyroidism has adverse effects on the course of pregnancy and development of the fetus [2]. Several studies have reported that maternal hypothyroidism is associated with increased risks of abortions, stillbirths, preterm delivery, and pregnancy-induced hypertension [3–6]. Conversely, other reports have shown successful pregnancy outcomes in women who were profoundly hypothyroid [1].…”

Section: Introductionmentioning

confidence: 99%

Maternal Thyroid Dysfunction and Neonatal Thyroid Problems

Özdemir

Akman

Coşkun

et al. 2013

International Journal of Endocrinology

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Aim. To investigate obstetric features of pregnant women with thyroid disorders and thyroid function tests of their newborn infants. Methods. Women with hypothyroidism and having anti-thyroglobulin (ATG) and anti-thyroid peroxidase (anti-TPO) antibodies were assigned as group I, women with hypothyroidism who did not have autoantibodies were assigned as group II, and women without thyroid problems were assigned as group III. Results. Pregnant women with autoimmune hypothyroidism (group I) had more preterm delivery and their babies needed more frequent neonatal intensive care unit (NICU) admission. In group I, one infant was diagnosed with compensated hypothyroidism and one infant had transient hyperthyrotropinemia. Five infants (23.8%) in group II had thyroid-stimulating hormone (TSH) levels >20 mIU/mL. Only two of them had TSH level >7 mIU/L at the 3rd postnatal week, and all had normal free T4 (FT4). Median maternal TSH level of these five infants with TSH >20 mIU/mL was 6.6 mIU/mL. In group III, six infants (6.5%) had TSH levels above >20 mIU/mL at the 1st postnatal week. Conclusion. Infants of mothers with thyroid problems are more likely to have elevated TSH and higher recall rate on neonatal thyroid screening. Women with thyroid disorders and their newborn infants should be followed closely for both obstetrical problems and for thyroid dysfunction.

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“…Moreover, Sahu et al (2010) reported a relatively high prevalence of 44–52% cesarean sections in a small group of patients with hypothyroidism, compared to 36% in the control group (Sahu et al, 2010). Wasserstrum & Anania (1995) reviewed 43 pregnancies of women with hypothyroidism and reported an increased rate of cesarean section due to fetal distress in women with ‘severe hypothyroidism’ (Wasserstrum & Anania, 1995). A previous study based on our population database, found a cesarean sections rate of 30% in pregnancies complicated by hypothyroidism (Cohen et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Hypothyroidism and diabetes mellitus – a risky dual gestational endocrinopathy

Tirosh

Benshalom-Tirosh

Novack

et al. 2013

PeerJ

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Objectives. Diabetes mellitus (DM) and hypothyroidism are each associated with increased rate of pregnancy complications. However, their combined morbidity during gestation is poorly studied. Therefore, the aims of this study were to determine the prevalence of the combined morbidity of DM & hypothyroidism and whether it is associated with adverse maternal and neonatal outcome.Study design. This population based retrospective cohort study included 87,213 women who had 232,293 deliveries. All deliveries were divided into the following groups: (1) hypothyroidism & DM (n = 171); (2) hypothyroidism (n = 1502); (3) DM (n = 13,324); and (4) deliveries of women with neither endocrinopathy, who served as a control group (n = 217, 296).Results. The prevalence of DM & hypothyroidism in our population was 0.17%. In comparisons to the other study groups, women with DM & hypothyroidism had higher rates of infertility (p < 0.001), preeclampsia (p < 0.001), chronic hypertension (p < 0.001), preterm birth (p < 0.001), and cesarean deliveries (p < 0.001). In Generalized Estimating Equations (GEE) model, hypothyroidism & DM was an independent risk factor for cesarean section (OR 3.46; 95% CI 2.53–4.75) and for preeclampsia (OR 1.82; 95%CI 1.16–2.84).Conclusion. The combination of DM & hypothyroidism is rare, yet it is associated with higher rate of infertility, cesarean sections, preterm deliveries, and hypertensive disorders of pregnancy than the rest of the population. This dual endocrinological combination is an independent risk factor for preeclampsia and cesarean section. These findings suggest that these patients are at risk for perinatal complications and should be followed and delivered as high risk pregnancies.

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Perinatal consequences of maternal hypothyroidism in early pregnancy and inadequate replacement

Cited by 89 publications

References 25 publications

Thyroid autoimmunity and obstetric outcomes in women with recurrent miscarriage: a case–control study

Thyroid autoimmunity and obstetric outcomes in women with recurrent miscarriage: a case–control study

Maternal Thyroid Dysfunction and Neonatal Thyroid Problems

Hypothyroidism and diabetes mellitus – a risky dual gestational endocrinopathy

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