Thyroid function abnormalities and antithyroid antibody prevalence in pregnant women at high risk for gestational diabetes mellitus

Abstract

Both gestational diabetes mellitus (GDM) and thyroid dysfunction in pregnancy compromise maternal and fetal health. The aim of the present study was to determine the prevalence of abnormal thyroid function and antithyroid antibodies during early pregnancy in a population at high risk for GDM. Serum free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were measured in 301 pregnant women who underwent routine 'universal screening' for GDM. The antithyroid peroxidase antibody (antiTPOAb) was also quantified in 255 of these women. GDM was confirmed by a 75-g oral glucose tolerance test using World Health Organization criteria. No statistically significant difference was found between the 80 (26.6%) women with GDM and the 221 (73.4%) women without GDM for any of the thyroid function tests. In the cohort tested for antiTPOAb, the 51 (20.0%) women who were positive for antiTPOAb had higher mean TSH (1.57 +/- 2.49 mIU/l; p < 0.001) than the women negative for antiTPOAb. Seventeen (5.6%) women had low FT4 while 12 (4.0%) women had high TSH; 28 (9.3%) women had low serum TSH, among whom three (1.0%) also had high FT4. The significantly higher prevalence of hypothyroxinemia and antiTPOAb titers than generally reported warrants routine screening for thyroid abnormalities. This screening, which can be effectively and easily incorporated into screening practices already in place for GDM, would result in improved obstetric care.

Subclinical Hypothyroidism in Pregnancy - A Case Series

“…Feely et al documented that SCH coexisted in 30% cases of GDM 55 . Many other literatures have also documented an association of thyroid abnormalities, notably overt and subclinical hypothyroidism as well as autoimmune thyroiditis with GDM [56][57][58][59][60] . This correlation has been substantiated by depiction of an inverse association between Metforfin and TSH level 61,62,63 .…”

Thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus: a cross-sectional study

“…They observed no statistically significant difference in free T 4 level between 2 group of gestational diabetes and healthy pregnant women. 18 Although, in a study, Velkoska et al indicated significant differences in free T 4 level in three groups of GDM, diabetes mellitus type I, and control group (11.7, 13.8, and 13.8 respectively) (p value <0.0001). In current study, women with gestational diabetes had normal TSH, but 10 % of them had free T 4 level below normal range.…”

“…Several studies showed contradict findings, which found no significant differentiate between GDM and non GDM groups regarding anti-TPO level. [17][18][19] In a study done by Agarwal et al, they observed that increased TSH level was associated with higher anti-TPO level (p value <0.001). 18 Velkoska et al reported prevalence of positive anti-TPO test in GDM, diabetes mellitus type I, and control group (15%, 30.8%, and 10% respectively).…”

“…[17][18][19] In a study done by Agarwal et al, they observed that increased TSH level was associated with higher anti-TPO level (p value <0.001). 18 Velkoska et al reported prevalence of positive anti-TPO test in GDM, diabetes mellitus type I, and control group (15%, 30.8%, and 10% respectively). The results of study by Vitacolonna and et al showed the rate of positive thyroid antibodies test in GDM, and control group (17.6% and 14.4% respectively).…”

“…16,17 Several studies showed no statistically significant difference in TSH serum level between gestational diabetes group and healthy group. 14,15,17,18 In a study by Karakosta et al conducted on 1170 pregnant women. In this study thyroid tests showed that presence of high level TSH and gestational autoimmune thyroid disorder increases risk of gestational diabetes up to 4 fold, and the risk of low birth weight up 3 times.…”