Endocrine Abstracts

Introduction: Thyroid disorders are quite common during pregnancy complicated by diabetes mellitus.

Objective: The aim of our study was to detect thyroid disorders in a group of diabetic pregnant women.

Patients and methods: Rétrospective study involving 243 pregnant women with diabetes followed in consultation or hospitalized in Endocrinology and Diabetology department of Ibn Rochd University Hospital of Casablanca, over a period from January 2016 to Octobre 2018. Data collection was done from medical records. All women had been interrogated for personal and family history of dysthyroidism and a complete physical examination. They had benefited from a biological assessment including the couple FT4-TSH. The evaluation of thyroid status referred to the 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum.

Résults: Mean age of women was 32 years old (18–49). They have on average 4 gestations, 2 parities and 2 live children. 36.6% of patients had gestational diabetes and 63.6% had pre-gestational diabetes (43.62% type 2 diabetes, 19.75% type 1 diabetes). The average term at first consultation was 21.6 weeks of amenorrhea (5–37): 49.5% were in the first trimester of pregnancy while 37.7% and 12.6% were respectively in the 2nd and 3rd trimester. The average TSH was 1.44±0.96 uIU/mL (0.28–5.28) while FT4 was 11.35±1.94 pmol/l (6.16–15.74). 25.10% of women suffered from some form of thyroid disorder, mostly (55.73%) hypothyroidism. Thyroid dysfunction was not associated with the type of diabetes mellitus (GDM or PGDM) (P<0.05). Nearly half of these patients had been put on L-thyroxine. This treatment was recommended in patients with a thyrotropin level higher than 2.5 mui/l. Hyperthyroidism was noticed in 44.26% of our patients and was dominated by gestational transient thyrotoxicosis (62.96%).

Conclusion: The study findings warrant routine screening for thyroid abnormalities in diabetic pregnant women. These women have increased rate of maternal and neonatal complications.