Prevalence of Subclinical Hypothyroidism in Pregnancy and Its Association With Anti-thyroperoxidase Antibody and the Occurrence of Gestational Diabetes Mellitus

Prakruti Dash; Rajlaxmi Tiwari; Saurav Nayak; Saubhagya K Jena; Manaswini Mangaraj

doi:10.7759/cureus.21087

Prevalence of Subclinical Hypothyroidism in Pregnancy and Its Association With Anti-thyroperoxidase Antibody and the Occurrence of Gestational Diabetes Mellitus

Cureus. 2022 Jan 10;14(1):e21087. doi: 10.7759/cureus.21087. eCollection 2022 Jan.

Authors

Prakruti Dash¹, Rajlaxmi Tiwari², Saurav Nayak¹, Saubhagya K Jena³, Manaswini Mangaraj¹

Affiliations

¹ Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.
² Biochemistry, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, IND.
³ Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.

Abstract

Introduction Subclinical hypothyroidism (SCH) and gestational diabetes mellitus (GDM) are common endocrinological abnormalities associated with pregnancy. The presence of a raised anti-thyroperoxidase (anti-TPO) antibody titer increases the risk of progression of subclinical hypothyroidism to overt hypothyroidism. Subclinical hypothyroidism and GDM are known to affect maternal and fetal outcomes adversely. A few studies have shown an increased risk of GDM with autoimmune hypothyroidism. However, data regarding this association between GDM, SCH, and anti-TPO Ab are scarce. This study aimed to find the prevalence of autoimmune subclinical hypothyroidism and its association with GDM in pregnancy. Materials and methods In a cross-sectional study, 382 pregnant women at their first antenatal checkup (ANC) were enrolled in the study. Serum thyroid-stimulating hormone (TSH), free T4 (FT4), anti-TPO Ab, and the 75 g oral glucose tolerance test (OGTT) were evaluated. The results obtained were analyzed in Systat Version 13.2 (SPSS Inc., Chicago, IL). Observations Results showed an SCH prevalence of 37.69% with a raised anti-TPO Ab titer in 49.31% of the diagnosed SCH cases, pointing towards an autoimmune etiology. Our study revealed a GDM prevalence of 12.04%. Out of the 46 GDM cases, 16 were found to have SCH and 3 cases had raised anti-TPO Ab titers. In our study, 27.73% of euthyroid pregnant women had a raised anti-TPO Ab titer. Our study revealed no significant association between GDM, SCH, and raised anti-TPO Ab titer. Conclusion Anti-TPO antibody subsequently leads to hypothyroxinemia, for which it is necessary that cases with high titer of anti-TPO antibody though euthyroid should be meticulously followed up and screened for to detect development of hypothyroidism or SCH, particularly in future pregnancies. However, GDM prevalence was at par with the national figure, but with no significant association of SCH and a high anti-TPO ab titer was found with GDM in our study. Further studies with a larger cohort may establish a causal association between the two most common endocrinological disorders observed in pregnancy.

Keywords: anti tpo ab; euthyroid; gdm; prevalence; sch.