Subclinical hypothyroidism (SCH) in first trimester of pregnancy.

Abstract

Objectives: The prime objective of this study was to evaluate and asses the prevalence and related complications of SCH in pregnant ladies in their 1^st trimester of pregnancy in Pakistani population. Study Design: Cross Sectional study. Setting: Department of Medicine, Teaching Hospital, DG Khan, Pakistan. Period: 11^th February 2017 to 29^th December 2018. Material & Methods: We obtained informed consent from all patients. 457 pregnant ladies having last missed period till 12^th week with age group between 18-45 years were included in this study. Samples were collected for T4 (Thyroxine), TSH (Thyroid Stimulating Hormone) and T3 (Triiodothyronine). Patients were followed for their entire pregnancy period.  Adverse events and complications were noted. Results: Out of 457 patients who were included in our study, 169 subjects had TSH levels well above 4.6- 10 mIU/L. 288 subjects were having TSH levels below 4 mIU/L. The overall prevalence of subclinical hypothyroidism (SCH) was found to be 37% in pregnant women during their first trimester of pregnancy. Pregnant women having subclinical hypothyroidism (SCH) were having higher risks of loss of pregnancy, placental abruption and neonatal death rates as compared to euthyroid pregnant women. Conclusion: Our study concludes that overall prevalence of subclinical hypothyroidism (SCH) in Pakistani pregnant women during their first trimester of pregnancy was found to be 37%. Pregnant women having subclinical hypothyroidisms (SCH) were having higher risks of loss of pregnancy, placental abruption and neonatal death rates as compared to euthyroid pregnant women. In the light of these findings we recommend routine screening for TSH, free T3 and free T4 during pregnancy especially during 1^st trimester of pregnancy.