Perinatal complications and their association with maternal hypothyroidism

Abstract

Introduction. Hypothyroidism in pregnant patients is more often associated with pregnancy complications. It increases the risk of obesity, diabetes, and hypertensive disorders, and has an impact on perinatal outcomes. There is a greater risk of congenital hypothyroidism or so-called cretinism, manifested by growth restriction, mental retardation and other neurophysiological defects. Iodine supplementation and proper administration of thyroxine preparations in the first and second trimesters significantly reduce neurological abnormalities. Purpose. Evaluation of pregnancies in patients with hypothyroidism and its impact on perinatal complications. Material and methods. The patients with hypothyroidism were analyzed from the total deliveries at the University Clinic for Gynecology and Obstetrics in Skopje. Patients are divided into two study groups: study and control groups. The study group includes patients with hypothyroidism. The control group includes patients without hypothyroidism. Results. The likelihood of obesity was assessed, and during the third trimester, the likelihood of developing diabetes, gestational hypertension, and preeclampsia as a single risk, was compared between the two groups. Patients with hypothyroidism are 3.49 times more likely to have obesity and 5.57 times higher risk of developing diabetes in pregnancy than those without hypothyroidism. The relative risk of developing gestational hypertension is 3.1 and OR 3.22 in patients with hypothyroidism, which means that 3.22 times more likely to develop gestational hypertension in this group. Preeclampsia develops in 2 patients (3.33%) with a relative risk of 2.07 and OR 2.11, or 2.11 times higher risk of developing preeclampsia in the hypothyroidism group. Conclusion. Early detection of thyroid disorders in a pregnant patient as well as in newborns postpartum allows for proper treatment of both mother and child, while uncontrolled hypothyroidism leads to adverse pregnancy outcomes and has fatal consequences.