Impact Of Maternal Hypothyroidism In Women With Gestational Diabetes Mellitus And Its Adverse Pregnancy Outcomes In South-Indian Population- A Prospective Study

Abstract

Introduction: The concurrent influence of Gestational diabetes mellitus (GDM) and hypothyroidism on the incidence of hypothyroidism
in GDM is not yet clearly reported. Thyroid dysfunction has been associated with adverse obstetric outcomes. However, less is known
regarding subclinical hypothyroidism and its relationship to pregnancy complications.
Methods: This prospective study was conducted with a total of 300 antenatal patients with GDM according to DIPSI criteria after 24
weeks and above were subjected to thyroid function tests. Patients with normal FT3, normal FT4 and S.TSH between 3.0mIU/L -10.0
mIU/L were diagnosed as Subclinical hypothyroidism and S.TSH more than 10.0mIU/L were diagnosed as Overt hypothyroidism.
These patients were followed up and both maternal-fetal outcomes were observed in GDM patients with and without hypothyroidism.
Results: In the study, 14% of GDM women developed hypothyroidism, all of which were subclinical. When compared to GDM women,
patients with combined endocrinopathy were more prone for Hypertensive Disorders (HD) in pregnancy. Other foetal outcomes, such
as preterm delivery (P= 0.384), RDS (P= 0.465), sepsis (P= 0.366), and jaundice in newborns (P= 0.193), and maternal outcomes
included anemia (P= 0.720), abruptio placenta (0%), mode of delivery (P= 0.9), and oligohydramnios were not statistically significant.
Conclusion: The incidence of hypothyroidism in GDM patients was only 14%. The incidence of HD in Pregnancy was more in
combined endocrinopathy (26.19%) compared to GDM (13.57%) (P=0.035). This indicates the increased incidence of HD in
Pregnancy, which emphasizes the importance of overseeing pregnancy as HD in Pregnancy may result in significant maternal- neonatal
complications.