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. 2024 Dec 19;10(1):50.
doi: 10.1186/s40842-024-00212-6.

Impact of maternal thyroid dysfunction on fetal and maternal outcomes in pregnancy: a prospective cohort study

Roshni Vamja  1 , Yogesh M  1 , Monika Patel  1 , Vijay Vala  2 , Arya Ramachandran  1 , Bhumika Surati  1 , Jay Nagda  3
Affiliations

Impact of maternal thyroid dysfunction on fetal and maternal outcomes in pregnancy: a prospective cohort study

Roshni Vamja et al. Clin Diabetes Endocrinol. .

Abstract

Background: Thyroid dysfunction in pregnancy can adversely impact maternal and fetal outcomes. However, the association between thyroid status and specific adverse outcomes needs clarity, especially in understudied regions.

Objective: This prospective cohort study aimed to illuminate the multifaceted associations between maternal thyroid dysfunction and feto-maternal outcomes in Gujarat, India.

Methods: This hospital-based cohort study recruited and monitored 500 euthyroid, 250 hypothyroid, and 150 hyperthyroid pregnant women until delivery. Maternal thyroid status was determined by serum thyroid stimulating hormone (TSH) and free thyroxine (fT4) levels. Adverse fetal outcomes included preterm birth, neonatal intensive care unit (NICU) admission, respiratory issues, and low APGAR scores. Maternal outcomes included preeclampsia, haemorrhage, hypertension, postpartum thyroiditis, and thromboembolism. Relative risks quantified associations between thyroid dysfunction and outcomes.

Results: Compared to euthyroid women, hypothyroid women had a higher RR for preterm birth (RR 1.8, 95% CI 1.1-3.0), low APGAR score (RR 2.5, 95% CI 1.5-4.1), preeclampsia (RR 3.0, 95% CI 1.9-4.8), postpartum haemorrhage (RR 1.6, 95% CI 1.2-2.1), and venous thromboembolism (RR 3.1, 95% CI 1.7-5.7). Hyperthyroid women had over twice the risk of low APGAR score (RR 1.8, 95% CI 0.9-3.5), neonatal hypoglycemia (RR 1.5, 95% CI 0.5-4.3), respiratory distress (RR 1.4, 95% CI 0.7-2.8), and postpartum thyroiditis (RR 2.3, 95% CI 1.1-4.8).

Conclusion: Maternal thyroid dysfunction escalates risks for adverse fetal and maternal outcomes. Thyroid monitoring and management during pregnancy are critical to mitigate complications.

Keywords: Fetal outcomes; Hyperthyroidism; Hypothyroidism; Maternal outcomes; Pregnancy; Relative risk.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Good clinical care guidelines were followed, and the guidelines were established as per the Helsinki Declaration 2008. All the participants were given clear instructions about the study before the start of the study. Written informed consent was obtained from the patients in their vernacular language for study participation, and no identifying information or images were included in the original article, which was submitted for publication in an online open-access publication. The entire methodology and protocol were approved by the Institutional Ethical Committee of Shri M P Shah Government Medical College, Jamnagar, Gujarat, India. Ethical approval was obtained from Shri MP Shah Govt Medical College & GG Hospital (ref No: 253/01/2022). Consent for publication: Not Applicable. Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart for participant recruitment process
See this image and copyright information in PMC

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