DOI: 10.36347/sjams. 2015.v03i09.061

Pages: 3446-3456

Background: Thyroid dysfunction, particularly hypothyroidism, is a common endocrine disorder during pregnancy with potential adverse effects on maternal and fetal health. This study aimed to determine the prevalence of hypothyroidism among pregnant women and evaluate its impact on maternal and fetal outcomes. Methods: This prospective observational study included 100 pregnant women attending the antenatal clinic during their first trimester at Department of Obstetrics & Gynecology, BSMMU, Dhaka, Bangladesh from January to December 2014. Thyroid function tests (TSH, FT4, FT3, and anti-TPO antibodies) were performed at enrollment. Women were classified as euthyroid, overt hypothyroid, subclinical hypothyroid, or TPO-positive euthyroid based on trimester-specific reference ranges. Hypothyroid women received levothyroxine treatment with periodic monitoring. All participants were followed throughout pregnancy, and maternal and fetal outcomes were recorded. Results: The prevalence of hypothyroidism was 22%, with subclinical hypothyroidism (18%) being more common than overt hypothyroidism (4%). Additionally, 11% of women were TPO antibody positive with normal thyroid function. Advanced maternal age (≥35 years), higher BMI, family history of thyroid disorders, and previous history of miscarriage were identified as significant risk factors for hypothyroidism. Women with hypothyroidism had higher rates of pregnancy-induced hypertension (27.3% vs. 10.3%, p=0.041), preeclampsia (18.2% vs. 3.8%, p=0.034), gestational diabetes mellitus (22.7% vs. 7.7%, p=0.047), and cesarean delivery (54.5% vs. 32.1%, p=0.049) compared to euthyroid women. Similarly, adverse fetal outcomes including low birth weight (27.3% vs. 10.3%, p=0.041), lower mean birth weight (2742±486g vs. 3126±412g, p=0.008), and increased NICU admissions (31.8% vs. 11.5%, p=0.020) were more frequent in the hypothyroid group. A significant negative correlation was observed between maternal TSH levels and birth weight (r=