Publication:

Pregnancy outcome in anti-thyroid peroxidase antibody negative subclinical hypothyroid women with and without treatment

Background There is insufficient evidence in the literature whether pregnancy with anti-thyroid peroxidase antibody negative subclinical hypothyroidism is benefited with treatment.

Methods The 100 uncomplicated primigravida women before 16 weeks of gestation who were anti thyroid peroxidase antibody negative and diagnosed as subclinical hypothyroid based on serum thyroid stimulating hormone (TSH), Free T4 (FT4) and anti-thyroid peroxidase antibody (anti TPO Ab) were enrolled in this study. They were divided into case and control group having 50 patients in each arm. Case group were treated with levothyroxine therapy as per the recommended dose. Maternal and perinatal outcome were compared between the two groups.

Results In our study we had found increased percentage of cases of antepartum hemorrhage (APH), pregnancy induced hypertension (PIH), pre-labour rupture of membrane (PROM), preterm delivery, meconium-stained liquor, intrauterine growth restriction (IUGR), low birth weight (LBW), APGAR score at 1 and 5 minutes, neonatal hyperbilirubinemia and NICU admission among women who were not treated but it was not statistically significant when compared with control group.

Conclusions When compared between the treated and non-treated group in anti TPO Ab negative subclinical hypothyroid patients, we didn’t find any significant difference in parameters studied by us. In view of inadequate literature, controversy exists whether to treat or not anti TPO negative subclinical hypothyroidism in pregnancy with levothyroxine.