Prevalence of Hypothyroidism in Unexplained Recurrent Miscarriages

Abstract

AIM AND OBJECTIVES:To establish the prevalence and association of hypothyroidism in women affected with unexplained recurrent miscarriages. MATERIAL AND METHODS: This is an Observational case control study conducted in Obstetrics and Gynecology Department of NIMS Medical College and Hospital, Jaipur (Rajasthan); between July 2011 to June 2012.One hundred nonpregnant women with history of recurrent pregnancy losses were included in study group and one hundred non-pregnant women of similar age group with at least one successful pregnancy outcome were taken as control. All women who had known Thyroid disorder, diabetes, collagen and heart disease, were excluded from study. Detailed history, thorough physical examination was done and subjected to the quantitative estimation of triiodothyronine {T3}, Thyroxin {T4} and TSH hormone by CLIA method. RESULT: In the study 63% women experienced two or more pregnancy loss while 37% presented with three or more pregnancy losses. Total 7 patients were reported to have hypothyroidism out of which 3 were observed with subclinical hypothyroidism while 4 were detected overt hypothyroidism. In Control group 2 patient of subclinical hypothyroidism were detected. CONCLUSION: Prevalence of Hypothyroidism was 7 % and it has a statistically significant relationship with recurrent pregnancy losses in <20 weeks of gestation. Screening for thyroid dysfunction should be done early in pregnancy. Looking at the high percentage of abnormal TSH in pregnancies; universal screening should be considered as impaired thyroid function may predispose to miscarriage. KEY WORDS: Hypothyroidism, tri-iodothyronine{T3}, Thyroxin{T4} and TSH hormone, recurrent pregnancy losses. INTRODUCTION:Thyroid disorders are among the common endocrine disorders in pregnant women. It is now well established that not only overt hypothyroidism but also subclinical thyroid dysfunction can have adverse effects on fetal and maternal outcome. Maternal hypothyroidism during pregnancy raises serious concern about long-lasting psycho-neurologic consequences for the progeny, due to the risk of insufficient placental transfer of maternal thyroid hormones to the developing fetus during the first half of gestation. 1 The risk for miscarriage increased by 15% for each 1mlU/l elevation of the TSH level on the basis of logistic regression analysis. 2 During the last decade there has been an increasing appreciation of the incidence of thyroid dysfunction during pregnancy as well as the resultant adverse maternal and fetal effects. 3,4,5 In the hope that many of these adverse effects could be prevented or ameliorated by early detection and appropriate treatment the proposal to implement screening for thyroid function during pregnancy deserves consideration. To validate the need of antenatal screening for maternal thyroid dysfunction this study was undertaken to the prevalence of thyroid dysfunction among pregnant women in India. Recurrent pregnancy loss (RPL) is defined as three or more consecutive spontaneous pregnancy

Can Early Thyroid Profiling Help Avert Spontaneous Abortions/Early Pregnancy Loss: A Retrospective Study

“…To minimize maternal and fetal deleterious effects of hypothyroidism in India, more national research are needed to assess the prevalence and etiology of hypothyroidism [ 13 ]. Hypothyroidism was shown to be common in 7% of the population [ 14 ], and it has a statistically significant link to recurrent pregnancy losses in the first 20 weeks of pregnancy. Thyroid dysfunction should be checked early on in pregnancy.…”

“…Thyroid dysfunction should be checked early on in pregnancy. Given the high prevalence of aberrant TSH in pregnancies, universal screening should be considered because poor thyroid function may increase the risk of miscarriage [ 14 ]. In all three groups, TSH was highly linked to abortion in the first trimester [ 15 ].…”

Endocrine dysfunction and recurrent spontaneous abortion: An overview

“…It is more prevalent (7%) during pregnancy and there is a statistical significant relationship of hypothyroidism with recurrent pregnancy loss in < 20 weeks of gestation. [ 49 ] The most prevalent cause of hypothyroidism in pregnant women, affecting approximately 0.5% of patients is chronic autoimmune thyroiditis. The TSH levels above 6 mIU/ml are significantly associated with higher frequency of still birth[ 50 ] and risk increases by 15% for each 1 mIU/ml elevation.…”