January 2016 · Volume 5 · Issue 1 Page 62 International Journal of Reproduction, Contraception, Obstetrics and Gynecology Mahajan KS et al. Int J Reprod Contracept Obstet Gynecol. 2016 Jan;5(1):62-67 www.ijrcog.org pISSN 2320-1770 | eISSN 2320-1789 Research Article Thyroid disorders in antenatal women in a rural hospital in central India Kalyani S. Mahajan 1 *, Chella Hariharan 1 , Satish N. Mahajan 2 , Deepti S. Shrivastava 1 INTRODUCTION Thyroid physiology plays a major role in pregnancy and thyroid disorders constitute one of the most common endocrine disorders in pregnancy. 1 Pregnancy is associated with significant and reversible changes in thyroid function. During pregnancy, there is an enhanced urinary loss of iodine owing to an increased glomerular filtration rate, leading to iodine deficiency and maternal goitre. 2 There is an increase in thyroxine-binding globulin (TBG) because of elevated oestrogen and decrease in the level of thyroid-stimulating hormone (TSH) with an increase in human chorionic gonadotropin concentration. 2 Placenta produces the enzyme deiodinase, which increases the peripheral metabolism of thyroid hormones and regulates the transplacental transport of thyroid hormone and iodide. 2 In essence, pregnancy is a stress for the thyroid, resulting in hypothyroidism in women with limited thyroidal reserve or iodine deficiency. The physiological changes of pregnancy can simulate thyroid disease. Symptoms of heat intolerance, sluggishness, fatigue, constipation and examination findings of tachycardia, edema, and wide pulse pressure 1 Department of Obstetrics & Gynaecology, Jawaharlal Nehru Medical College, Sawangi-Meghe, Wardha, Maharashtra, India 2 Department of Medicine, Jawaharlal Nehru Medical College, Sawangi-Meghe, Wardha, Maharashtra, India Received: 20 October 2015 Accepted: 12 December 2015 *Correspondence: Dr. Kalyani S. Mahajan, E-mail: kalyanimahajandr@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Thyroid disorders are one of the most common endocrine disorders in pregnancy. Thyroid disorders are known to be associated with abnormal maternal and fetal outcomes and are often overlooked in pregnant women because of nonspecific symptoms and hypermetabolic state of pregnancy. Methods: 514 women between 12 to 18 weeks of pregnancy from October 2013 to September 2015were recruited in the study. Serum thyroid-stimulating hormone (TSH) testing was done. Free T4 and free T3 were tested in subjects with a deranged TSH value. Subjects were followed up till delivery, and maternal and fetal complications arising out of thyroid dysfunction were studied. Results: The occurrence of subclinical hypothyroidism was 9.54%, overt hypothyroidism was 2.34% and hyperthyroidism was 0.58%. When compared to subjects with euthyroidism, anemia and preterm delivery were the most significant maternal complications in subjects with hypothyroidism (p=0.0001 and 0.0001, respectively) whereas miscarriage, IUD/stillbirth, LBW and intrauterine growth restriction were significant fetal complications observed in subjects with hypothyroidism, with p<0.0001, p=0.002, 0.025, 0.009 respectively. NICU admissions were 2.58 times more in subjects with thyroid disorders as compared to euthyroid subjects. Conclusions: The occurrence of thyroid disorders was high in our study with associated adverse maternal and fetal outcomes. Routine screening for thyroid dysfunction is recommended to prevent adverse fetal and maternal outcomes. Serum TSH is a sufficient and cost-effective screening tool. Keywords: Thyroid dysfunction, Fetal outcome, Maternal outcome DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20151602