Abstract

Background: Subclinical hypothyroidism (SCH) during pregnancy is increasingly recognized as a contributor to adverse maternal and fetal outcomes, yet consensus regarding universal screening and treatment remains debated. This study aimed to evaluate pregnancy outcomes in women with subclinical hypothyroidism

Material andMethods: This prospective observational study was conducted in the Department of Biochemistry in collaboration with the Department of Obstetrics at Dr. S.S. Tantia Medical College and affiliated hospitals, Sri Ganganagar. A total of 270 pregnant women were screened for thyroid dysfunction. Among them, 173 were diagnosed with SCH and 37 with overt hypothyroidism. Maternal characteristics, gestational age, obstetric outcomes, and fetal outcomes were compared. Thyroid profile parameters (T3, T4, TSH, FT3, FT4) and anti-thyroid peroxidase (anti-TPO) antibodies were analyzed. Statistical analysis was performed using SPSS version 16.

Results: The prevalence of SCH in pregnancy was 64.0%. Women with SCH were predominantly aged 26–30 years. Preeclampsia, preterm delivery, and pregnancy loss were significantly higher in overt hypothyroidism compared to SCH. Among SCH women, levothyroxine treatment significantly reduced pregnancy loss, preterm birth, and neonatal unit admissions. Elevated anti-TPO antibodies were observed in 94.2% of SCH cases and showed a significant positive correlation with TSH levels.

Conclusion: Subclinical hypothyroidism is highly prevalent in pregnant women and is associated with adverse pregnancy outcomes. Early detection and appropriate levothyroxine therapy, particularly in anti-TPO positive women, significantly improve maternal and fetal outcomes. These findings support routine screening and timely management of thyroid dysfunction during pregnancy.