Evaluation of thyroid dysfunctions frequency in the first trimester

Year 2022, , 466 - 470, 15.03.2022

Kazım Uçkan , İzzet Çeleğen , Yusuf Başkıran

https://doi.org/10.32322/jhsm.1015213

Abstract

Aim: The aim of the study is to determine the frequency of first-trimester thyroid dysfunction in pregnant women and to investigate the effect of thyroid dysfunction on some perinatal outcomes.
Material and Method: In the study, first-trimester Thyroid stimulating hormone (TSH), free T4 and free T3 hormone values of pregnant women who applied to our outpatient clinic were retrospectively scanned and recorded. As a result, 3224 pregnant women were included in the study. Pregnant women were evaluated as overt hypothyroidism, subclinical hypothyroidism, overt hyperthyroidism, subclinical hyperthyroidism and euthyroid according to TSH and fT4 values. Results of thyroid function tests of pregnant women and some perinatal results (age, gestational week, delivery type, baby gender, birth weight, gravida, parity, abortion) were compared
Results: In our study, the mean age of the pregnant women for screening was 28.6±3.1, the mean birth week was 38.7±2.1, and the mean birth weight was 3037±324.73.6% (n=2369) of the pregnant women were normal euthyroid, 0.71% (n=23) were subclinical hyperthyroidism, 0.65% (n=23) were overt hyperthyroidism, while 15.6% (n=507) were overtly hypothyroid and 9.4% 3 (n=304) were found to be subclinical hypothyroidism. A significant statistical difference was not found between thyroid outcome test results and perinatal outcomes (age, gravida, parity, abortion, birth strength, gestational age, delivery type, babies) (p> 0.05).
Conclusion: In our study, a high prevalence of thyroid disease, especially hypothyroidism, was observed in pregnant women. More studies should be done to evaluate the effect of thyroid functions on pregnancy outcomes.

Keywords

First trimester, Pregnancy, Thyroid dysfunction, TSH, Perinatal outcomes

References

• Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd W, Leveno KJ, Cunningham FG. Subclinical hypothyroidism and pregnancy outcomes. Obstet. Gynecol 2005; 105: 239-45.
• Glinoer D. Thyroid regulation and dysfunction in the pregnant patient. Thyroid 2004; 14: 234-45.
• Girling JC. Thyroid disorders in pregnancy. Curr Obstet Gynecol 2006; 16: 539-47.
• Fisher DA. Fetal thyroid function: diagnosis and management of fetal thyroid disorders. Clin Obstet Gynecol 1997; 40: 16-31.
• Türkiye Endokrinoloji ve Metabolizma Derneği, Tiroid Hastalıkları Tanı ve Tedavi Kılavuzu 2017.
• Delshad H, Azizi F. Thyroid and pregnancy. J Med Counc Iran 2008; 26: 392–408.
• Negro R, Mestman JH. Thyroid disease in pregnancy. Best Pract Res Clin Endocrinol Metab 2011; 25: 927–43.
• Thyroid disease in pregnancy. American College of Obstetrics and Gynecology. Int J Gynaecol Obstet; 2002; 79: 171-80.
• El Baba KA, Azar ST. Thyroid dysfunction in pregnancy. Int J Gen Med 2012; 5: 227–30.
• Utiger RD. Maternal hypothyroidism and fetal development. N Engl J Med 1999; 341: 601.
• Sawyer HP, Denice SF. Maternal thyroid disease and its effects on the fetus and perinatal outcomes. Prenatal diagnosis, 2020; 40: 1077-84.
• Mulik J, Pratapan P, Agrawal N. Study of thyroid disorders in pregnancy & its effect on maternal & perinatal outcomes at a tertiary care centre. Hypertension 2019; 42: 40.
• Cignini P, Cafà EV, Giorlandino C, Capriglione S, Spata A, Dugo N. Thyroid physiology and common diseases in pregnancy: review of literature. J Prenat Med 2012. p. 2012; 6: 64–71
• Andersen S, Bruun NH, Pedersen KM, Laurberg P. Biologic variation is important for interpretation of thyroid function tests. Thyroid 2003; 13: 1069-78.
• Nazarpour S, RamezaniTehrani F, Simbar M, Azizi F. Thyroid dysfunction and pregnancy outcomes. Iran J Reprod Med 2015; 13: 387–96.
• Sun YL, Howard JC, Ann A, Elizabeth NP . Associations between maternal thyroid function in pregnancy and obstetric and perinatal outcomes. J Clin Endocrinol Metab 2020; 105: 2015-23.
• Li C, Shan Z, Mao J, et al. Assessment of thyroid function during first-trimester pregnancy: what is the rational upper limit of serum TSH during the first trimester in Chinese pregnant women?. J Clin Endocrinol Metab 2014; 99: 73–9.
• Rajput R, Goel V, Nanda S, Rajput M, Seth S. Prevalence of thyroid dysfunction among women during the first trimester of pregnancy at a tertiary care hospital in Haryana. Indian J Endocr Metab 2015; 19: 416-9.
• Khan KA, Akhter MS, Fatima K, Saleem MW. Subclinical hypothyroidism (SCH) in first trimester of pregnancy. Prof Med J 2020; 27: 2474-7.
• Sepasi F, Rashidian T, Shokri M, Badfar G, Kazemi F, Azami M. Thyroid dysfunction in Iranian pregnant women: a systematic review and meta-analysis. BMC Pregnancy Childbirth, 2020; 20: 1-15.
• Korde VR, Barse SP, Barla JS. Prevalence of thyroid dysfunctions in pregnant women: a prospective study in a tertiary care hospital in Maharashtra, India. Int J Reprod Contracep Obstet Gynecol 2018, 7.8: 3211-6.
• Güzel E, SivriAydın D, Çilesiz Göksedef BP, Boran AB. The incidence of thyroid dysfunction in pregnant women. Perinat J 2015; 23: 96-100.
• Seven A, Kucur SK, Polat M, Yüksel B, Işıklar Ö, KeskinN. Gebelerde birinci trimester tiroid fonksiyon testi sonuçlarının değerlendirilmesi. Muğla Sıtkı Koçman Üniv Tıp Derg 2016; 2: 5-8.
• Bulmus N, Ustuner I, Guven ESG, Sahin FK, Senturk S, Sahin SB. Thyroid diseases in pregnancy: the importance of anamnesis.Pakistan J Med Sci 2013; 29: 1187.
• Morreale de EG, Obregon MJ, Escobar del RF. Role of thyroid hormone during early brain development. Eur J Endocrinol 2004; 151: 25-37
• Zhang C, Yang X, Zhang Y, et al. Association between maternal thyroid hormones and birth weight at early and late pregnancy. J Clin Endocrinol Metab 2019; 104: 5853-63.
• Johns LE, Ferguson KK, Cantonwine DE, Mukherjee B, Meeker JD, McElrath TF. Subclinical changes in maternal thyroid function parameters in pregnancy and fetal growth. J Clin Endocrinol Metab 2018; 103: 1349-58.
• Derakhshan A, Peeters RP, Taylor PN, et al. Association of maternal thyroid function with birthweight: a systematic review and individual-participant data meta-analysis. Lancet Diabet Endocrinol 2020; 8: 501-10.
• Alvarez-Pedrerol M, Guxens M, Mendez M, et al. Iodine levels and thyroid hormones in healthy pregnant women and birth weight of their offspring. Eur J Endocrinol 2009; 160: 423–9.
• Bakacak M, Serin S, Avcı F, et al. Maternal ilk trimester tiroid stimülan hormone düzeylerinin miadında doğan fetüslerin doğum ağırlıklarına etkisi. Perinatoloji Derg 2015; 23: 79–83.
• Poppe K, Velkeniers B, Glinoer D. The role of thyroid autoimmunity in fertility and pregnancy. Nat Clin. Pract Endocrinol Metab 2008; 4: 394–405.
• Abalovich M, Amino N, Barbour LA, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2007; 92: 47.
• Liu Y, Chen H, Jing CLF. The association between maternal subclinical hypothyroidism and growth, development, and childhood intelligence: a meta-analysis. J Clin Res Pediatr Endocrinol 2018; 10: 153.
• Gönç E, Yordam N. Çocukluk ve adölesanda tiroid hastalıkları. Günöz H, Öcal, G, Yordam, N, Kurtoğlu, S. Pediatrik Endokrinoloji. 1. ed. s212-19, Kalkan Matbaacılık, Kayseri, 2003.
• Ashoor G, Maiz N, Rotas M, Jawdat F, Nicolaides KH. Maternal thyroid function at 11–13 weeks of gestation and spontaneous preterm delivery. Obstet Gynecol 2011; 117: 293-8.
• Günkaya OS, Kıyak H, Ekiz A, Gedikbaşı A. İlk trimesterda tiroid fonksiyonunun gebelik sonuçları. Perinatoloji Derg 2017; 25: 121–6.