Evaluation and Treatment of Subclinical Hypothyroidism and Adverse Pregnancy Outcomes

Background: Subclinical hypothyroidism (SCH) is a common biochemical entity identified in women during pregnancy. SCH is diagnosed when the thyroid stimulating hormone (TSH) is elevated with a normal free thyroxine (FT4) level. Although most women with SCH are asymptomatic, previous studies have shown that SCH may be associated with adverse outcomes during pregnancy. The thyroid hormone, FT4, is necessary for fetal growth and development. Insufficient thyroid hormone has been shown to impair fetal growth and brain development and it may have negative effects on neonatal survival. Women with overt hypothyroidism during pregnancy require levothyroxine treatment. Methods and materials: The study was retrospective cross-sectional study which conducted in Tripoli university hospital at obstetrics and gynecology department during 1st May 2021 to 30th June 2022. The study data was carried out from medical record among pregnant women who’s diagnosed by subclinical hypothyroidism which selected and filled by predesigned structural questionnaire. Results: Among 136 pregnant women who diagnosed by subclinical hypothyroidism in Tripoli university hospital whose aged between 23 to 45 years with mean age 37.08 ± 5.799 SD. Distribution of obstetrical data frequency for mean and SD: gestational age (mean was 3.01 ± 0.471 SD), gravidity (mean was 2.89 ± 0.883 SD), parity (mean was 3.09 ± 0.977 SD) and abortion (mean was 1.74 ± 1.047 SD and on evaluating the type of abortion 73% were missed, 18% were complete and only 9% were incomplete abortion). Regarding smoking status, 66.8% were non smoker while 32.3% were passive smoker and just 1% was active smoker. On determine the co morbidity with subclinical hypothyroidism, 45.6% had diabetes mellitus followed by 17.5% had hypertension. Majority of pregnant women had delivered by cesarean section which scored 76.3% while 23.7% had delivered vaginally. On evaluating the maternal complications, 40% had abruption placenta followed by 37.2% had diabetic ketoacidosis while only 1% had maxedema coma. On evaluating the neonatal complications, 23.4% had preterm delivery followed by 21.4% were macrosomic newborn while just 3.6% had developed Cretinism. Conclusion: In this study the subclinical hypothyroidism among pregnant women show to have various adverse health outcomes to the mothers and their newborn with adjacent additional risk factors such as diabetes mellitus and hypertension the health hazard become high.