Publication:

Thyroid stimulating hormone and thyroid peroxidase antibodies assessment in screening of hypothyroidism in pregnancy

Background Thyroid dysfunction in pregnancy is often underdiagnosed due to overlapping physiological changes, yet it poses significant risks to maternal and foetal outcomes. This study aimed to evaluate role of anti-thyroid peroxidase (TPO) antibodies alongside thyroid stimulating hormone (TSH) in diagnosing and guiding treatment for hypothyroidism in pregnant women.

Methods A prospective cohort study was conducted from September 2019 to June 2021 at a tertiary hospital in Mumbai among antenatal women at booking visit. TSH, free T4, and anti-TPO antibodies were measured using chemiluminescent immunoassay. Follow-up and treatment were based on trimester-specific reference ranges and standard guidelines. Statistical analysis was done with significance set at p 4 mIU/l and was started on treatment. At third follow-up, 5 out of 69 participants had TSH >4 mIU/l and were also treated accordingly.

Conclusions A significant association was observed between elevated TSH levels and presence of anti-TPO antibodies. A notable decrease in mean TSH levels was observed in second and third visits compared to baseline values among pregnant women with borderline TSH, without thyroid hormone supplementation.