Adequacy of Levothyroxine Treatment in Subclinical Hypothyroid Pregnant Women and Its Association with Maternal and Fetal Outcomes

Background & Objective: Subclinical hypothyroidism in pregnancy is defined as TSH raised above the pregnancy specific reference range and with normal Free T۴. The aim was to study maternal and fetal outcomes among subclinical hypothyroid pregnant women, and determine its association with attainment of target TSH levels post levothyroxine treatment.Materials & Methods: This cross-sectional study was conducted at a Tertiary care hospital, Mysuru, India. The study included ۱۶۸ antenatal women who fulfilled the criteria for subclinical hypothyroidism. Group A included women with subclinical hypothyroidism treated with levothyroxine who attained target TSH. Group B included women with subclinical hypothyroidism who did not attain the target TSH. The groups were compared for overall maternal and fetal outcomes. Descriptive statistics and inferential statistics like the Chi square test were used to find the association between TSH level and maternal, fetal, and other factors.Results: Among the participating mothers, ۱.۲% had abortions and ۴۳.۵% had other antenatal complications. With respect to the neonates born, ۲۵.۳% had low birth weight (<۲.۵ Kg), ۲۰.۸% of the neonates were admitted to NICU and over all neonatal complications were noted in ۳۹.۲%. Maternal outcome, Neonatal outcome, birth weight and NICU admissions were significantly statistically associated with the attainment of normal TSH levels at third trimester, whereas mode of delivery and APGAR score were not found to be associated.Conclusion: Levothyroxine treatment for subclinical hypothyroidism in pregnancy is associated with decreased risk of overall maternal and neonatal complications in women who attain target TSH after treatment.

Keywords:

Maternal-Fetal , Hypothyroidism , Levothyroxine pregnancy , Pregnancy Outcome