FREQUENCY OF HYPOTHYROIDISM AND ITS ASSOCIATION WITH PERINATAL AND OBSTETRIC MORBIDITY AMONG WOMEN ADMITTED FOR DELIVERY
DOI:
https://doi.org/10.71000/40r5n920Keywords:
Hypothyroidism, , pregnancy complications, , obstetric morbidity, Fetal Distress, Low Birth Weight, Thyroid Dysfunction, Thyroid-Stimulating HormoneAbstract
Background: Hypothyroidism is the second most prevalent endocrine disorder during pregnancy after diabetes mellitus. It is associated with a range of maternal and perinatal complications when left untreated, including hypertensive disorders, hemorrhagic complications, and impaired fetal development. The physiological changes in thyroid function during pregnancy make early detection critical for maternal and neonatal health. Despite global awareness, region-specific data remain limited, especially in low-resource settings like Pakistan.
Objective: To determine the frequency of hypothyroidism among pregnant women admitted for delivery at Abbasi Shaheed Hospital/KMDC, Karachi, and to assess its association with perinatal and obstetric morbidity.
Methods: A cross-sectional descriptive study was conducted from March to September 2024, enrolling 170 pregnant women aged 18–49 years with a gestational age ≥28 weeks. Serum levels of TSH, free T4, and free T3 were evaluated. Hypothyroidism was diagnosed based on TSH >4 mU/L, free T4 <10 ng/mL, or free T3 <0.8 ng/mL. The outcomes assessed included pre-eclampsia, postpartum hemorrhage (PPH), antepartum hemorrhage (APH), fetal distress, low birth weight (LBW <2,500 g), preterm delivery (<37 weeks), and NICU admission. Associations were analyzed using chi-square and logistic regression, with p < 0.05 considered statistically significant.
Results: Out of 170 participants, 54 (31.8%) had hypothyroidism. Pre-eclampsia occurred in 12 (22.2%) hypothyroid vs. 8 (6.7%) euthyroid women (p = 0.001). PPH was noted in 10 (18.5%) vs. 5 (4.0%) (p = 0.003), and fetal distress in 9 (16.7%) vs. 7 (5.3%) (p = 0.007), respectively. LBW was significantly higher in the hypothyroid group—16 (29.6%) vs. 14 (12.0%) (p = 0.002). No significant differences were found for APH (3.7% vs. 0.9%), preterm delivery (16.7% vs. 12.9%), or NICU admission (13.0% vs. 9.3%).
Conclusion: Hypothyroidism was prevalent in nearly one-third of pregnant women and was significantly associated with pre-eclampsia, PPH, fetal distress, and LBW. These findings support the integration of routine antenatal thyroid screening, including TPO antibody testing, to enable early diagnosis and intervention, thereby improving pregnancy outcomes.
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Copyright (c) 2025 Maryam Shahid, Shabnum Shamim Asim, Sumera Mehmood, Ramsha Ashkar, Syeda Nousheen Tabasum, Atka Ahmad (Author)
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