Association of feto-maternal outcomes in pregnant women with thyroid dysfunction
DOI:
https://doi.org/10.55629/pakjpathol.v37i2.982Abstract
Objective: To determine the frequency of thyroid disorders in pregnant women and its association with adverse pregnancy outcomes for mother and the fetus.
Material and Method: This prospective cohort study was conducted at Chemical Pathology and Endocrinology department, Reference laboratory at Rawalpindi in collaboration with Gynaecology department of tertiary care hospital at Rawalpindi from 28 August 2023 to 28 February 2024. Pregnant women without diagnosed endocrine disorders in third trimester were included in this study and observed till delivery for feto-maternal outcomes. Blood samples were collected after a detailed history. Fetomaternal outcomes were compared between women with thyroid disorders and euthyroid participants by using the chi-square test and odds ratios to calculate the estimated risk.
Results: Among 174 pregnant women enrolled, 152 (87.35%) were euthyroid and 22 (12.65%) had thyroid dysfunction. The frequency of anaemia (36.4% vs 5.3%), pre-eclampsia (18.2% vs 3.3%) and low APGAR score (27.3% vs 3.9%) were higher in females with thyroid dysfunction with a p value <0.05. However, no significant differences were observed in cesarean section, gestational diabetes mellitus, preterm labor, NICU admission, or low birth weight (p>0.05). Thyroid dysfunction was associated with increased odds of anaemia (OR 6.91), pre-eclampsia (OR 5.53), and low APGAR score (OR 6.91), whereas associations with other maternal and neonatal outcomes were not statistically significant.
Conclusion: Pregnant women with thyroid dysfunction have a higher risk of adverse feto-maternal outcomes. Early detection and management of thyroid dysfunction could help prevent these complications.
Keywords: Euthyroid, Feto-maternal outcomes, Pregnancy, Thyroid dysfunction
References
Puthiyachirakal MA, Hopkins M, Al-Natsheh T, Das A. Overview of thyroid disorders in pregnancy. Matern Health Neonatol Perinatol. 2025; 11(1): 9. DOI: https://doi.org/10.1186/s40748-025-00208-9
Sabbithi S, Prasanna MS, Ekka A, Vaishnavi D. Feto-maternal and neonatal complications associated with hypothyroidism in pregnancy. International J Pharmacy Pharmaceutical Sci. 2023; 37–42. DOI: https://doi.org/10.22159/ijpps.2023v15i12.48588
Vamja R, M Y, Patel M, et al. Impact of maternal thyroid dysfunction on fetal and maternal outcomes in pregnancy: A prospective cohort study. Clin Diabetes Endocrinol. 2024; 10 (1): 50. DOI: https://doi.org/10.1186/s40842-024-00212-6
Springer D, Jiskra J, Limanova Z, Zima T, Potlukova E. Thyroid in pregnancy: From physiology to screening. Crit Rev Clin Lab Sci. 2017. DOI: https://doi.org/10.1080/10408363.2016.1269 309
Buczyńska A, Sidorkiewicz I, Hryniewicka J, Zbucka-Krętowska M, Dzięcioł J, Szelachowska M, et al. Pregnancy associated thyroid disorders: The role of genetic, epigenetic, and oxidative stress factors. Rev Endocr Metab Disord. 2025; 26(4): 679-92. DOI: https://doi.org/10.1007/s111 54-025-09974-5 .
Andersen SL. Frequency and outcomes of maternal thyroid function abnormalities in early pregnancy. Scand J Clin Lab Invest. 2019; 79(1-2): 99-107. DOI: https://doi.org/10.1080/00365513.2018.1555 858 .
Talat A, Khan AA, Nasreen S, Wass JA. Thyroid screening during early pregnancy and the need for trimester specific reference ranges: A Cross-Sectional study in Lahore, Pakistan. Cureus. 2019; 11(9): e5661.
DOI: https://doi.org/10.7759/cureus.5661
Zahra S, Qayyum S, Chohan MA, Amin A, Essa M, Mansoor M, et al. Association between thyroid dysfunction among pregnant women with bad obstetric history a comprehensive study. J Health Rehabilitation Res. 2024; 4(2): 1381–5. DOI: http://dx.doi.org/10.61919/jhrr.v4i2.1092
Stagnaro-Green A, Pearce E. Thyroid disorders in pregnancy. Nat Rev Endocrinol. 2012; 8(11): 650-8. DOI: https://doi.org/10.1038/nrendo.2012.171
Mahadik K, Choudhary P, Roy PK. Study of thyroid function in pregnancy, its feto-maternal outcome; A prospective observational study. BMC Pregnancy and Childbirth. 2020; 20(1): 769. DOI: https://doi.org/10.1186/s12884-020-03448-z
Raza N, Sarwar I, Munazza B, Ayub M, Suleman M. Assessment of iron deficiency in pregnant women by determining iron status. PubMed [Internet]. 2014; 23(2): 36-40. Available from: https://pubmed.ncbi.nlm.nih.gov/24800338
Jahangir AM, Fariduddin M, Ali HM, Ahmed KM, Ali SM. Thyroid dysfunction and maternal and fetal complications in pregnancy: a study in a tertiary care Hospital, Dhaka, Bangladesh. IOSR J Dental Med Sci (IOSR-JDMS). 2020; 19(11): 60-67. DOI: https://doi.org/10.9790/0853-1911066067
Bibi N, Inam I, Hassan G. Association of thyroid dysfunction and pregnancy outcomes. PJMHS. 2021; 15(12): 3367–9. Available from: https://pjmhsonline.com/2021/dec/3367.pdf
Dhanwal D, Prasad S, Agarwal A, Dixit V, Banerjee A. High prevalence of subclinical hypothyroidism during first trimester of pregnancy in North India. Indian J Endocrinol Metab. 2013; 17(2): 281. DOI: https://doi.org/10.4103/2230-8210.109712
Kiran Z, Sheikh A, Humayun KN, Islam N. Neonatal outcomes and congenital anomalies in pregnancies affected by hypothyroidism. Ann Med. 2021; 53(1): 1560-8. DOI:https://doi.org/10.1080/07853890.2021.1970798
Nambiar V, Jagtap VS, Sarathi V, Lila AR, Kamalanathan S, Bandgar TR, et al. Prevalence and impact of thyroid disorders on maternal outcome in Asian-Indian pregnant women. J Thyroid Res. 2011; 2011: 1-6.
DOI: https://doi.org/10.4061 /2011/429097
Kumar R, Bansal R, Shergill HK, Garg P. Prevalence of thyroid dysfunction in pregnancy and its association with feto-maternal outcomes: A prospective observational study from a tertiary care institute in Northern India. Clin Epidemiol Global Health. 2022; 19: 101201. Available from: https://doi.org/10.1016/j.cegh.2022.101201
Chen S, Zhou X, Zhu H, Yang H, Gong F, Wang L, et al. Preconception TSH and pregnancy outcomes: A population‐based cohort study in 184 611 women. Clin Endocrinol. 2017; 86(6): 816–24. DOI: https://doi.org/10.1111/cen.13329
Khan MA, Alam MJ, Goit SK, Fariduddin M. The frequency and pattern of thyroid disorders in pregnant women during the first antenatal visit. J Assoc Clin Endocrinol Diabetol Bangladesh. 2024; 3(2): 40–6. DOI: https://doi.org/10.3329/jacedb.v3i2.78640
Omar J, Quereshi MA, Durrani HM, Shabbir N, Liaqat J. Association of neonatal outcome with maternal thyroid dysfunction. J Soc Obstet Gynaecol Pak. 2024; 14(2):117-122. Available from: https://jsogp.net/index.php/jsogp/article/ view/781
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