Title: Effect of Overt and Subclinical Hypothyroidism on Pregnancy and Childbirth
Authors: Prof. Dr Nandini Vamadevan Ratnamma, Dr Reji Mohan, Prof. Dr Nirmala Chellamma
DOI: https://dx.doi.org/10.18535/jmscr/v5i11.98
Abstract
Aim: Our study is to find out the effect of overt and subclinical thyroid dysfunction on pregnancy and outcomes in our hospital.
Materials and Methods: This is a case control study conducted in Sree Avittom Thirunal Hospital, Government Medical College, Thiruvananthapuram and study period was for one year.
Results: In our study hypothyroidism was detected in 71.8% of cases <30 years and the mean age was 26.29 years, median was 25.5 years, age group varied froml8 to 33 years. Mean age was 24.88 years, median was 27 years and the age group varied from 20 to 34 years among the controls. Religion wise, socioeconomic class wise and parity wise cases and controls were comparable. Cases had 3.6 the risk of developing threatened abortion, 3.8 times the risk of developing gestational hypertension, 3.6 times the risk of getting postpartum haemorrhage.25.6% of cases and 20.5% of the controls developed preterm labour.5.1% of cases and 2.6% of controls had abruption with a higher risk among the cases. Caesarean section was done in 51.3% of cases and 28.2% of the controls. Congenital goiter was seen in 2.6% of cases and 1.3% of controls. Congenital malformations were observed in 7.7% of cases and 5.1% of controls. Congenital hyperbilirubinemia was seen in 6.4% of cases and 2.6% of controls. Congenital hypothyroidism was observed in 5.1% of cases and 2.1% of controls. Early neonatal deaths were seen in 5.1% of cases and 3.8% of controls. Stillbirths were observed in 6.4% of cases and 5.1% of the controls.
Conclusion: This study recommends treatment for all women who have overt thyroid disease. Antenatal women who are diagnosed and treated hypothyroidism will probably need an increased dosage of thyroid medication during pregnancy, and should be periodically tested and treated. Women with thyroid conditions requires the care of a high-risk obstetrician. Women who are hypothyroid should give birth at a hospital that is experienced in the postnatal care of babies. Women should use prenatal vitamins containing iodine, which is essential for thyroid function.
