PREVALENCE AND CLINICAL IMPLICATIONS OF HYPOTHYROIDISM AMONG PREGNANT WOMEN IN THE FIRST TRIMESTER: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Objective: Thyroid disorders, particularly hypothyroidism, pose significant risks to both pregnant women and their fetuses. This prospective observational study aimed to investigate the prevalence and clinical implications of hypothyroidism among pregnant women in the first trimester in a hilly region of North India. Methods: The study included 300 pregnant women attending the antenatal clinic at Shri Lal Bahadur Shastri Government Medical College and Hospital, Mandi (HP), between April 1, 2021, and March 31, 2022. Participants were categorized into two groups based on their thyroid-stimulating hormone (TSH) levels: Group A (TSH 2.5-10.0 mIU/l) and Group B (TSH>10 mIU/l). Thyroid function was assessed through TSH, free T4, and free T3 measurements. Maternal and fetal outcomes were monitored throughout pregnancy. Results: The study found an overall hypothyroidism prevalence of 11.31%, comprising 10.98% subclinical hypothyroidism (SCH) and 0.33% overt hypothyroidism (OH). These findings were consistent with similar studies in North India. Participants had a mean age of 28.7±5.2148 y, resembling demographic data from hilly regions. A majority of participants belonged to the lower-middle-income group and resided in rural areas, reflecting the socio-demographic distribution in the region. The gestational age ranged from 6 to 12 w, with an average of 9.31±1.5 w. The average TSH level was notably higher than in other Indian studies, potentially due to the geographical altitude. Conclusion: The study highlights the need for early detection and management of thyroid dysfunction during pregnancy, especially in hilly regions, to prevent maternal and fetal complications. This research addresses a knowledge gap and emphasizes the importance of thyroid screening during the first prenatal visit in similar settings.