ASSOCIATION BETWEEN MATERNAL THYROID FUNCTION AND PREGNANCY OUTCOMES: A CLINICAL ANALYSIS.

Abstract

Background: Thyroid dysfunction during pregnancy, including subclinical hypothyroidism and isolated hypothyroxinemia, is associated with adverse maternal and neonatal outcomes. Despite its clinical significance, thyroid dysfunction remains underdiagnosed, leading to preventable complications such as preterm delivery and fetal growth restriction. This study investigates the association between maternal thyroid function and pregnancy outcomes to provide insights into clinical management.

Objective: To evaluate the relationship between maternal thyroid dysfunction and adverse pregnancy outcomes, focusing on subclinical hypothyroidism and isolated hypothyroxinemia.

Methods: This prospective cohort study included 450 pregnant women categorized into three groups based on thyroid function: normal thyroid function (n=300), subclinical hypothyroidism (n=80), and isolated hypothyroxinemia (n=70). Thyroid-stimulating hormone (TSH), free thyroxine (FT4), and thyroid peroxidase antibodies (TPOAb) were measured in the first trimester. Pregnancy outcomes, including preterm delivery, preeclampsia, small-for-gestational-age (SGA) births, and neonatal intensive care unit (NICU) admissions, were recorded. Multivariate logistic regression was used to adjust for confounding variables, and statistical significance was set at p<0.05.

Results: Subclinical hypothyroidism was associated with a higher risk of preterm delivery (15% vs. 7%) and SGA births (20% vs. 8.5%) compared to normal thyroid function. Isolated hypothyroxinemia was linked to increased NICU admissions (15.5%) and lower Apgar scores. Both conditions were associated with elevated risks of preeclampsia, highlighting their clinical relevance.

Conclusion: Maternal thyroid dysfunction significantly increases the risk of adverse pregnancy outcomes, emphasizing the need for routine thyroid function screening and early intervention during pregnancy. These findings contribute to evidence-based recommendations for improved maternal and neonatal health outcomes.