Background: Pregnancy is a state where changes in maternal physiology influence thyroid status. In addition, thyroid disease in mother can have substantial adverse outcome on the pregnancy and fetus. The objective of this study was to establish correlation of maternal TSH with PAPP-A, Beta HCG, Inhibin, uE3, AFP and HCG and compare pregnancy outcomes in subclinical hypothyroid pregnant women with euthyroid women.
Methodology: 110 out of 150 singleton pregnant women were recruited randomly and analysed from high risk antenatal clinic at tertiary care institute in State of Uttar Pradesh, North India for a period from June 2015 to June 2019. Multiple and IVF conceived pregnancies and those with gross congenital malformation were omitted. They were grouped in Group A (n=60) with Normal TSH values at time of booking and Group B (n=50) with values more than 2.5 miu/l. The medical records were retrieved from the centralized database. Biochemical screening, antenatal complication and pregnancy outcome were noted and compared between the two groups.
Statistical analysis: comparison was done with the statistical software SPSS version 20. T test was performed for independent variable testing and chi square was used for logistic variables. Confidence interval was 95% and P value was <0.05 considered significant.
Results: Significant correlation was found TSH values and Birth weight. 31.42% of neonates were low birth-weight in study group vs. 13.34% in control group. Alfa-fetoprotein, Human chorionic gonadotrophin and Inhibin A were positively correlated and uE3, PAPP-A and Beta subunit of human chorionic gonadotrophin were negatively correlated with levels of TSH, though this was not significant.
Conclusion: Subclinical Hypothyroidism is endemic in northern India. Early diagnosis and prompt treatment can improve pregnancy outcomes and prevent foetal complications. Efforts of triaging the diagnostic modalities with other biochemical markers can offer better risk analysis and help in management strategies.