Table 2.
Clinical features and maternal outcomes of hypothyroid pregnancies who had TSH measured before conception and during each trimester at Aga Khan University
| Preconception TSH data | 1st Trimester TSH data | 2nd Trimester TSH data | 3rd Trimester TSH data | |
|---|---|---|---|---|
| CLINICAL CHARACTERISTICS | N (%) N = 377 | N (%) N = 402 | N (%) N = 437 | N (%) N = 471 |
| Age (years) | ||||
| 18–25 | 31 (8.22) | 47 (11.7) | 57 (13.0) | 60 (12.7) |
| 26–33 | 221 (58.62) | 234 (58.2) | 253 (57.9) | 271 (57.5) |
| 34–40 | 119 (31.56) | 111 (27.6) | 121 (27.7) | 131 (27.8) |
| 41–47 | 6 (1.59) | 10 (2.5) | 6 (1.4) | 9 (1.9) |
| Parity | ||||
| Nulliparous | 96 (25.81) | 126 (31.3) | 146 (33.4) | 147 (31.2) |
| Multiparous | 276 (74.19) | 269 (66.9) | 285 (65.2) | 312 (66.2) |
| Body Mass Index (Kg/m2) | ||||
| Underweight (< 18.5) | 13 (3.83) | 13 (3.2) | 16 (3.7) | 14 (3.0) |
| Normal (18.5–24.9) | 99 (29.20) | 118 (29.4) | 124 (28.4) | 120 (25.5) |
| Overweight (25–29.9) | 116 (34.22) | 124 (30.8) | 141 (32.2) | 138 (29.3) |
| Obesity class I (30–34.9) | 88 (25.96) | 81 (20.1) | 95 (21.7) | 103 (21.9) |
| Obesity class II and above (> = 35) | 23 (6.78) | 28 (7.0) | 28 (6.4) | 38 (8.1) |
| Hypothyroidism diagnosed during pregnancy | ||||
| Yes | 15 (4.00) | 38 (9.5) | 45 (10.3) | 46 (9.8) |
| No | 360 (96.00) | 361 (89.8) | 387 (88.6) | 413 (87.7) |
| Etiology of Hypothyroidism | ||||
| Autoimmune | 362 (96.28) | 390 (97.0) | 425 (97.3) | 457 (97.0) |
| Post treatmenta | 14 (3.72) | 12 (3.0) | 12 (2.7) | 14 (3.0) |
| Thyroid antibodies | ||||
| Positive | 114 (78.08) | 114 (28.4) | 115 (26.3) | 116 (24.6) |
| Negative | 32 (21.92) | 30 (7.5) | 42 (9.6) | 43 (9.1) |
| Comorbidities | ||||
| Diabetes Mellitus | ||||
| yes | 28 (7.43) | 34 (8.5) | 31 (7.1) | 34 (7.2) |
| no | 349 (92.57) | 368 (91.5) | 406 (92.9) | 437 (92.8) |
| Gestational diabetes mellitus | ||||
| yes | 82 (21.75) | 82 (20.4) | 99 (22.7) | 123 (26.1) |
| no | 295 (78.25) | 320 (79.6) | 338 (77.3) | 348 (73.9) |
| Hypertension | ||||
| Normotensive | 327 (86.74) | 353 (87.8) | 366 (83.8) | 396 (84.1) |
| Gestational Hypertension & Chronic Hypertension | 50 (13.26) | 49 (12.2) | 71 (16.2) | 75 (15.9) |
| MATERNAL OUTCOMES | ||||
| Mode of labor (for live births only) | ||||
| Spontaneous | 66 (33.00) | 75 (18.7) | 86 (19.7) | 94 (20.0) |
| Induced | 89 (44.50) | 84 (20.9) | 110 (25.2) | 123 (26.1) |
| Augmented | 45 (22.50) | 44 (10.9) | 55 (12.6) | 58 (12.3) |
| Not applicable due to Caesarean section | 145 (38.5) | 151 (37.6) | 171 (39.1) | 195 (41.4) |
| Mode of delivery (for live births only) | ||||
| Em-LSCS | 73 (19.4) | 72 (17.9) | 92 (21.1) | 109 (23.1) |
| LSCS | 131 (34.7) | 134 (33.3) | 148 (33.9) | 168 (35.7) |
| Instrumental | 13 (3.77) | 14 (3.5) | 18 (4.1) | 22 (4.7) |
| SVD | 128 (37.10) | 134 (33.3) | 164 (37.5) | 171 (36.3) |
| Pregnancy outcomes | ||||
| Abortion | 27 (7.16) | 33 (8.2) | 4 (0.9) | N/A |
| Live Birth (Twins/Triplets) | 344 (91.25) | 355 (88.3) | 422 (96.5) | 471 (100) |
| Ectopic | 1 (0.27) | 4 (1.0) | 0 (0) | N/A |
| Termination of Pregnancy | 1 (0.27) | 5 (1.2) | 5 (1.1) | 0 (0) |
| Intrauterine Death/Stillbirth | 4 (0.01) | 5 (1.2) | 6 (1.4) | 0 (0) |
| Gestational Hypertension | ||||
| Yes | 34 (9.0) | N/A | 52 (11.9) | 56 (11.9) |
| No | 343 (91.0) | 385 (88.1) | 415 (88.1) | |
| Pre-Eclampsia | ||||
| Yes | 10 (2.7) | N/A | 19 (4.3) | 20 (4.2) |
| No | 367 (97.3) | 418 (95.7) | 451 (95.8) | |
| Postpartum Hemorrhage | ||||
| Yes | 151 (40.1) | N/A | 178 (40.7) | 204 (43.3) |
| No | 226 (59.9) | 259 (59.3) | 267 (56.7) | |
| Placental abruption | ||||
| No | 377 (100) | N/A | 437 (100) | 1 (0.2) |
| Yes | 0 (0) | 0 (0) | 470 (99.8) | |
TSH Thyroid stimulating Hormone. N/A not applicable. LSCS Lower segment Caesarean section. Em-LSCS emergency Lower segment Caesarean section. SVD Spontaneous vaginal delivery
aPost medical treatment for Grave’s disease, Post-Radioactive Iodine Ablation and Post-Surgical