Table of Content Details

Abstract

Numerous studies worldwide have found inconsistent associations between subclinical
hypothyroidism (SCH) in pregnancy and adverse obstetrical outcomes including
miscarriage, fetal death, preterm delivery, gestational diabetes (GDM), hypertensive
disorders of pregnancy (HDP), placental abruption. This study aimed to further
evaluate and discuss on the outcomes of pregnancy with Anti-TPO antibodies in
patients with proven subclinical hypothyroidism and whether supplementation with
levothyroxine potentially reduces the adverse outcomes.
Patients with deranged TSH levels, normal free T4 levels, with either positive or
negative Anti- TPO antibodies were recruited in this study and followed till delivery/
miscarriage. It was found that the median S. TSH values in 1st trimester in Anti-TPO
positive women was 5.91μIU/ml while, in Anti- TPO negative women it was 4.87
μIU/ml. Out of 150 Anti- TPO positive pregnant women, 51 (34%) developed GDM
and 8 (5.3%) developed HDP while out of 150 Anti- TPO negative pregnant women,
39 (26%) developed GDM and only 1 (0.7%) developed HDP. Amongst Anti- TPO
positive mothers, 7 (4.7%) had missed abortion in first trimester, 13 (8.7%) had
RPL and 14 (9.3%) had threatened abortion, while none of these complications were
observed in the Anti- TPO negative mothers.
Thus, timely diagnosis and adequate supplementation can reduce the associated
maternal and fetal morbidity and improve the pregnancy outcomes even in women
with thyroid autoimmunity.

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