THE EFFECT OF LEVOTHYROXINE TREATMENT ON MATERNAL AND PERINATAL OUTCOMES IN PREGNANT WOMEN WITH SUBCLINICAL HYPOTHYROIDISM: A 5-YEAR RETROSPECTIVE STUDY AT A TERTIARY CARE HOSPITAL IN TURKEY

Authors : Halil İbrahim ERBIYIK, Rabia Merve PALALIOGLU

Pages : 297-310

Doi:10.59313/jsr-a.1252381

View : 35 | Download : 9

Publication Date : 2023-03-29

Article Type : Research Paper

Abstract :Subclinical hypothyroidism is characterized by elevated thyroid stimulating hormone insert ignore into journalissuearticles values(TSH); levels with normal free thyroxine insert ignore into journalissuearticles values(fT4); levels. The aim of this study was to compare obstetric and neonatal outcomes in pregnant women with and without treatment for subclinical hypothyroidism. In this study, maternal and perinatal outcomes were evaluated in a total of 270 pregnant women who were diagnosed with subclinical hypothyroidism as a result of screening performed in three trimesters of pregnancy between 2015 and 2020 and followed up in our clinic, 149 of whom received levothyroxine treatment and 121 of whom did not receive treatment. Further, different cutoff values for TSH were compared. The rates of neonatal intensive care unit insert ignore into journalissuearticles values(NICU); requirement were not different according to the levothyroxine use status of the patients insert ignore into journalissuearticles values(p=0.73, p>0.05);. Miscarriage rates did not differ according to levothyroxine use insert ignore into journalissuearticles values(p=0,87, p>0,05);. TSH, T4 and antithyroid peroxidase levels did not differ according to the maternal use of levothyroxine insert ignore into journalissuearticles values(p>0,05);. Birth weight, gestational week at birth, 1- and 5-minute APGAR scores, neonatal TSH and T4 levels did not differ according to the maternal use of levothyroxine insert ignore into journalissuearticles values(p>0,05);. Among the adverse maternal and perinatal outcomes, the need for NICU admission and the rates of placental abruption, fetal distress, preterm premature rupture of membranes, preeclampsia, preterm labor, and small for gestational age were not significantly different among the TSH cutoff groups insert ignore into journalissuearticles values(p>0,05);. The rate of premature rupture of membranes was higher in the group with TSH levels ≥2.5 mIU/L insert ignore into journalissuearticles values(p=0.04);. Choosing 2.5 mIU/L as the cutoff value for TSH levels allows early diagnosis of subclinical hypothyroidism with a higher rate in pregnant Turkish women and proactive therapeutic management. Our study provides limited evidence for the success of levothyroxine therapy for adverse obstetric and neonatal outcomes.
Keywords : Adverse pregnancy fetal outcomes, Levothyroxine, Pregnancy, Screening, Subclinical hypothyroidism, Thyroid hormone replacement

ORIGINAL ARTICLE URL