To Study Thyroid Dysfunction in Antenatal Women and Its Impact on Maternal and Fetal Outcome.

Background: Pregnancy has a profound impact on the thyroid gland and its functions. During pregnancy, the thyroid gland increases in size by 10% in iodine replete countries but by 20% to 40% in areas of iodine deficiency. Production of thyroid hormones and iodine requirement each increases by approximately 50% during pregnancy. Hypothyroidism in pregnancy is associated with significant obstetrical and fetal complications such as spontaneous or threatened miscarriage, anaemia, preeclampsia, preterm delivery, low birth weight, fetal growth restriction, placental abruption, postpartum haemorrhage, high perinatal mortality etc. This study is designed to evaluate the prevalence of thyroid dysfunction and its impact on maternal and fetal outcome in antenatal women attending antenatal clinic at a tertiary healthcare centre in Raipur, Chhattisgarh. Objectives: To study the prevalence of thyroid dysfunction in antenatal women and the impact of thyroid dysfunction on maternal and fetal outcome. Material And Methods: This was a prospective observational study with 113 healthy pregnant women attending the ante natal clinic of the Department of Obstetrics and Gynaecology between 8 to 26 weeks of gestation during the time period of 1st November 2018 to 31st October 2019. Statistical analysis was done using descriptive and inferential analysis. To establish association tests namely chi square test, ANOVA test and odds ratio were used. Level of significance P value <0.05 that is 5% was considered as statistically significant. Results: Out of 113 subjects 74.34% were euthyroid and 25.66 % had thyroid dysfunction in which 18.58% were subclinical hypothyroid, 6.19% were overt hypothyroid and 0.88 % were hyperthyroid. Abnormal maternal outcome was significantly higher (p=0.003) among subjects with thyroid dysfunction (58.62%) as compared to euthyroid subjects (30.95%). Abnormal fetal outcome was significantly higher (p=0.002) among anti-TPO positive hypothyroid subjects as compared to anti TPO negative hypothyroid subjects. NICU admission was needed by neonates of 47.05% and 75% of subjects with subclinical hypothyroidism and overt hypothyroidism respectively (p=0.0013). APGAR score <7 at 1 min after birth was significantly higher (p =0.0322) in neonates of subjects with thyroid dysfunction (36.36%) as compared to euthyroid subjects (15.58%). Conclusion: In India prevalence of hypothyroidism in antenatal women is much higher as compared to western countries. Prevalence also varies widely through different regions in India. Our study revealed a high prevalence of hypothyroidism in Mowa, Raipur, Chhattisgarh state in India. With our study we would like to conclude that both overt and subclinical hypothyroidism in antenatal women is significantly associated with adverse maternal and fetal outcomes and therefore needs to be monitored vigilantly for development of complications and timely interference to improve maternal and fetal outcome. [ABSTRACT FROM AUTHOR]