Thyroid disorders in antenatal women in a rural hospital in central India

Background: Thyroid disorders are one of the most common endocrine disorders in pregnancy. Thyroid disorders are known to be associated with abnormal maternal and fetal outcomes and are often overlooked in pregnant women because of nonspecific symptoms and hypermetabolic state of pregnancy. Methods: 514 women between 12 to 18 weeks of pregnancy from October 2013 to September 2015were recruited in the study. Serum thyroid-stimulating hormone (TSH) testing was done. Free T4 and free T3 were tested in subjects with a deranged TSH value. Subjects were followed up till delivery, and maternal and fetal complications arising out of thyroid dysfunction were studied. Results: The occurrence of subclinical hypothyroidism was 9.54%, overt hypothyroidism was 2.34% and hyperthyroidism was 0.58%.  When compared to subjects with euthyroidism, anemia and preterm delivery were the most significant maternal complications in subjects with hypothyroidism (p=0.0001 and 0.0001, respectively) whereas miscarriage, IUD/stillbirth, LBW and intrauterine growth restriction were significant fetal complications observed in subjects with hypothyroidism, with p<0.0001, p=0.002, 0.025, 0.009 respectively. NICU admissions were 2.58 times more in subjects with thyroid disorders as compared to euthyroid subjects. Conclusions: The occurrence of thyroid disorders was high in our study with associated adverse maternal and fetal outcomes. Routine screening for thyroid dysfunction is recommended to prevent adverse fetal and maternal outcomes. Serum TSH is a sufficient and cost-effective screening tool.