High prevalence of maternal hypothyroidism despite adequate iodine status in Indian pregnant women in the first trimester (original) (raw)
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Urinary iodine and thyroid determinants in pregnancy: a follow up study in Sri Lanka
BMC Pregnancy and Childbirth, 2016
Background: Iodine deficiency and thyroid dysfunction during pregnancy is associated with number of adverse outcomes that includes mental and physical disabilities creating a huge human and economic burden in later life. Several indicators are used to assess the iodine status of a population: thyroid size by palpation and/or by ultrasonography, urinary iodine excretion and the blood thyroid hormone profile. Methods: This prospective study was designed to assess the iodine nutrition during the course of pregnancy with reference to urine iodine concentration (UIC) and thyroid determinants among 425 pregnant women from Galle district, Sri Lanka. UIC was estimated in all three trimesters and thyroid functions were assessed in first and third trimesters. Results: Median (inter-quartile range IQR) UIC was 170.9 (100.0-261.10) μg/L, 123.80 (73.50-189.50) μg/L and 105.95 (67.00-153.50) μg/L in the first, second and third trimesters respectively (p < 0.001). Median thyroid stimulating hormone (TSH) level in the first trimester was 1.30 (0.80-1.80) µIU/mL. This value significantly increased (p < 0.001) to 1. 60 (1.20-2.10) µIU/mL at the 3 rd trimester even though it was maintained within the reference range (0.3-5.2 µIU/mL). In the assessment of thyroid gland, 67 (16.0 %) women had palpable or visible goitres and 55 (13.1 %) had a goitre that was palpable but not visible. The median thyroid volume of the sample was 5.16 mL (4.30; 6.10 mL) as measured by ultra sound (US) scanning. In multiple regression analysis after controlling for other independent variables (anthropometric, demographic and biochemical parameters); initial body mass index (BMI), goitre size, thyroid volume and parity had significant correlations with the third trimester urinary iodine levels. The thyroid volume accounted for 4.5 % of the urinary iodine variation. Conclusions: Even though iodine status was progressively worsening with the advancement of pregnancy and iodized salt consumption has not met with the increasing demand for iodine, it was not reflected in the serum TSH level. Therefore, it is worthwhile to assess the long term effects of rising TSH levels and inadequate iodine nutrition during pregnancy on the offspring to prevent even mild iodine deficiency.
Indian journal of endocrinology and metabolism
Iodine status of pregnant women and their newborns have not been studied in Jaffna District, Sri Lanka. This study was planned to assess the maternal iodine status and thyroid function at the third trimester of gestation and the thyrotrophin level of their neonate. Four hundred and seventy-seven pregnant women and their newborns were randomly selected among six Medical Officers of Health Divisions out of 12 in Jaffna District, Sri Lanka. Maternal thyroid stimulating hormone (TSH), free thyroxine (fT4), thyroglobulin (Tg), urinary iodine levels, and the neonatal thyrotrophin (nTSH) level were assessed. In this study, mean age, weight, height, and gestational age of the mothers were 28.95 (±5.46) years, 63.02 (±11.56) kg, 154.39 (±6.00) cm, and 39.33 (±1.37) weeks, respectively. Maternal median urinary iodine concentration (UIC) was 140.0 μg/L (inter-quartile range 126.0-268.0 μg/L). Median values of the maternal serum TSH, fT4, and Tg were 1.9 mIU/L, 12.6 pmol/L, and 21.4 IU/L, respe...
Status of iodine deficiency among pregnant mothers in Himachal Pradesh, India
Public Health Nutrition, 2014
ObjectiveIodine is an essential micronutrient needed for the production of thyroid hormones. Pregnant mothers who are deficient in iodine provide less iodine to the fetal thyroid. This results in low production of thyroid hormones by the fetal thyroid, thereby leading to compromised mental and physical development of the fetus. The current study aimed to assess the current status of iodine nutrition among pregnant mothers in Himachal Pradesh, India, a known endemic region for iodine deficiency.DesignThree districts, namely Kangra, Kullu and Solan, were selected.SettingIn each district, thirty clusters (villages) were identified by utilizing the population-proportional-to-size cluster sampling methodology. In each cluster, seventeen pregnant mothers attending the antenatal clinics were included.SubjectsA total of 1711 pregnant mothers (647 from Kangra, 551 from Kullu and 513 from Solan) were studied. Clinical examination of the thyroid of each pregnant mother was conducted. Spot urin...
Prevalence of thyroid disorders among pregnant women at a tertiary care hospital in Rajasthan
2021
Pregnancy can be viewed as a state in which a combination of events concur to modify the thyroidal economy. There is change in the level of thyroxinebinding globulin, total thyroid hormone level and change in the level of thyroid stimulating hormone (TSH) during normal pregnancy. Endemic iodine deficiency accounts for most of the cases of hypothyroidism in pregnant women worldwide while chronic autoimmune thyroiditis is the most common cause of hypothyroidism in iodine sufficient parts of the world. The presentation of hypothyroidism in pregnancy is not always classical and may sometimes be difficult to distinguish from the ABSTRACT
Archives of Gynecology and Obstetrics, 2010
Purpose Thyroid disorders are among the common endocrine problems in pregnant women. It is now well established that not only overt, but subclinical thyroid dysfunction also has adverse eVects on maternal and fetal outcome. There are few data from India about the prevalence of thyroid dysfunction in pregnancy. With this background, this study aims to Wnd prevalence of thyroid dysfunction in pregnancy and its impact on obstetrical outcome in Indian population. Methods Six hundred and 33 pregnant women in second trimester were registered. Detailed history and examination was done. Apart from routine obstetrical investigations, TSH level estimation was done. If TSH level was deranged then free T 4 and thyroperoxidase antibody level estimation were done. Patients were managed accordingly and followed till delivery. Their obstetrical and perinatal outcomes were noted. Results Prevalence of thyroid dysfunction was high in this study, with subclinical hypothyroidism in 6.47% and overt hypothyroidism in 4.58% women. Overt hypothyroids were prone to have pregnancy-induced hypertension (P = 0.04), intrauterine growth restriction (P = 0.01) and intrauterine demise (P = 0.0004) as compared to control. Cesarean section rate for fetal distress was signiWcantly higher among pregnant subclinical hypothyroid women (P = 0.04). Neonatal complications and gestational diabetes were signiWcantly more in overt hyperthyroidism group (P = 0.03 and P = 0.04, respectively). Conclusions Prevalence of thyroid disorders, especially overt and subclinical hypothyroidism (6.47%) was high. SigniWcant adverse eVects on maternal and fetal outcome were seen emphasizing the importance of routine antenatal thyroid screening.
Indian Journal of Endocrinology and Metabolism, 2015
Background: Undetected and untreated thyroid disorders are associated with adverse maternal and fetal outcomes. There are limited data on the prevalence of newly diagnosed thyroid disease during pregnancy from India. Therefore, this study was designed to evaluate the prevalence of thyroid dysfunction, especially hypothyroidism during the first trimester of pregnancy. Materials and Methods: The present cross-sectional study was conducted at Department of endocrinology and antenatal clinic in the Obstetrics and Gynecology Pt. B.D. Sharma PGIMS, Rohtak over a period of 1-year. The total sample population comprised of 461 pregnant women with uncomplicated intrauterine singleton pregnancies in the first trimester of gestation without any history of thyroid disease or intake of any thyroid medication. Morning blood samples from the participants were analyzed for thyroid function tests, which included FT3, FT4, thyroid-stimulating hormone (TSH) and anti-thyroid peroxidase antibodies (TPO). Results: A total of 461 women were enrolled for this study. Mean maternal age was 23.79 ± 3.47 years. Median gestational age was 8 weeks 5 days. The median FT3, FT4 and TSH were 3.3 pg/mL, 1.25 ng/dL, and 1.40 mIU/L, respectively. Anti-TPO was elevated in 128 (27.8%) pregnant women. 99 (21.5%) women had sub-clinical hypothyroidism and 39 (39.4%) among them were positive for anti-TPO (P ≤ 0.001). 2 (0.4%) of women had overt hyperthyroidism, whereas 15 (3.3%) of the women had sub-clinical hyperthyroidism. Conclusion: Considering the immense impact that maternal thyroid dysfunction has on maternal and fetal outcomes, prompt identification of thyroid dysfunction and its timely treatment is essential. Thus, universal screening of pregnant women for thyroid dysfunction should be considered especially in a country like India due to the high prevalence of thyroid dysfunction.
Iodine status and its determinants in subpopulation of pregnant women in rural Central India
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Iodine is an essential micronutrient during pregnancy and has a vital role to play in the synthesis of thyroid hormone. Disorders caused by severe iodine deficiency before or during pregnancy range from decreased fertility to trophoblastic or embryonic damage, miscarriage, stillbirth or increased infant mortality, cretinism, congenital abnormalities, and psychomotor defects. 1 Severe deficiency causes both maternal and fetal hypothyroidism and is associated with poor obstetric outcomes like spontaneous abortion, prematurity, and stillbirth.
International journal of reproduction, contraception, obstetrics and gynecology, 2018
Background: Thyroid dysfunction is known to be the commonest endocrinological disorder in pregnancy. A range of adverse outcomes in pregnant women and the fetus have been reported. These can be prevented if the thyroid dysfunction is diagnosed and treated as early as possible. There are limited studies conducted on the prevalence of thyroid dysfunction in pregnancy in India. Hence, this study was conducted for assessment of the prevalence of thyroid dysfunction in pregnancy. Methods: The present study is a prospective study conducted in the
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: The aim of the study is to determine the prevalence of thyroid dysfunction in pregnancy and its impact on obstetrical outcome in Eastern Uttar Pradesh.Methods: This was a prospective observational study undertaken at antenatal clinics and indoor of BRD Medical College, Gorakhpur. Total 720 antenatal women, ≤20 weeks of gestation were recruited for the study. In all patients’ routine obstetrical investigations and thyroid function tests were done. All patients were followed up to delivery. Maternal and perinatal outcome were ascertained.Results: Prevalence of thyroid dysfunction among pregnant was found to be 21.1% and subclinical hypothyroidism (15.9%) was the commonest thyroid disorder. Most common complication observed in subclinical and overt hypothyroidism was preeclampsia (9.56 % versus 20%) followed by preterm labour (7.82% versus 10%). Major fetal complications in hypothyroid mothers included intrauterine growth restriction, low birth weight and stillbirth.Conclus...