ENDEMIC HYPOTHYROID CHALLENGE ON THYROID STATUS OF PREGNANT WOMEN AND ADVERSE OUTCOMES
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Keywords
endemic hypothyroidism, pregnancy, thyroid function hormones, neonatal status, adverse outcomes
Abstract
Introduction: Pregnancy with thyroid dysfunction is a high risk for developing iodine deficit. All aspects of thyroid hormone economy affected by pregnancy. Thyroid Stimulating Hormone (TSH) level during pregnancy is most reliable test to assess thyroid functional status. Objectives: The study objectives were to assess pertinent thyroid functional hormones of pregnant women during last trimester and maternal & neonatal outcomes of pregnancy in this region. Materials & Methods: A cross sectional, hospital based study was conducted. Convenient sampling technique was practiced. Sample size was calculated by Classical Sample size Cochran formula. Maternal Goiterous and clinically Non-goiterous maternal groups were recruited for thyroid function status and outcomes of pregnancy. Results: Serum TSH levels of maternal Goiterous group were 1.33 ± 0.144 mIU/l, serum free triiodothyronine (FT3) levels were 2.51 ± 0.608 pmol/l, and serum free thyroxin (FT4) were 0.92 ± 0.691 ng/dl. Comparing the maternal Non-goiterous group serum TSH levels were 1.760 ± 0.155 mIU/l, FT3 levels were 1.710 ± 0,381 pmol/l and serum FT4 were 1.310 ± 0.194 ng/dl. Independent t-test was applied to evaluate equality of means and variances, of both maternal groups. Results have shown statistically significant (P <0.05). On percentile analysis serum TSH levels of maternal Goiterous, group 5th, 50th (median), and 95th percentiles were 0.134, 1.090, and 3.508 mIU/l respectively. In Maternal-neonatal outcome high frequency of abortion (29.3%) and low birth weight (LBW) (10.6%) were observed among maternal Goiterous group, Early neonatal deaths occurred (< 7days) 9.33% among neonates of maternal Goiterous group. Conclusion: Reduced thyroid function due to endemic goitrous prevalence in the study region demands regular screening for thyroid disorders during pregnancy in order to avoid its adverse consequences on fetal and neonatal differentiating development in general however specifically of brain to avoid wide spread mental retardation.
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Prof. Dr. Abdul Rehman Khokhar
MBBS, DCH, MCH&N, M.Phil., Ph.D. Scholar, Professor of Physiology/Ph.D. Scholar IMBB, University of Lahore, DGKMC, Dera Ghazi Khan, Principal, ORCID: 0000-0002-5335-8044
Dr. Muhammad Rafique Dar
Ph.D. Physiology, Associate Professor of Physiology, IMBB, University of Lahore, ORCID: 0000-0001-9218-6639
Prof. Dr. Abdul Majeed Cheema
MSc, Ph.D. Physiology, Professor of Physiology, IMBB, University of Lahore,