Publication:

Study on the occurrence of gestational diabetes mellitus in first trimester hypothyroid and euthyroid pregnant women

Background Hypothyroidism and gestational diabetes mellitus are two common endocrine complications in pregnancy. Individually, contributing to adverse outcomes. With the increase in the prevalence of subclinical hypothyroidism, the risk of the occurrence of gestational diabetes mellitus among pregnant women has increased. Thus, the purpose of this study is to determine the association between hypothyroidism and the subsequent onset of gestational diabetes. Introducing universal thyroid screening in the early stages of pregnancy, along with timely intervention, may help reduce the impact of both conditions on expectant mothers, thereby promoting healthier pregnancies and overall maternal well-being. This study aimed to determine the proportion of pregnant women with gestational diabetes mellitus among first-trimester (0- 12 weeks) hypothyroid and euthyroid pregnant women.

Methods This is a Prospective study conducted in the Department of OBG, ESIC-PGIMSR Bangalore between April 2023 to October 2024. Pregnant women who registered at the Antenatal OPD during their first visit, including both euthyroid and hypothyroid individuals, were followed up, and the prevalence of gestational diabetes mellitus among them, with maternal and fetal outcomes, has been evaluated.

Results In our study, the prevalence of GDM in patients with hypothyroidism is found to be 80%, with adverse maternal and fetal outcomes. Thus, the association of GDM with hypothyroidism has an increased risk of preterm delivery (22.5%), severe preeclampsia (10%), gestational hypertension (7.5%), anaemia (30%), placental abruption (5%), and an increased number of caesarean sections (72.5%), with an increased neonatal morbidity.

Conclusions Early universal screening and timely intervention for hypothyroidism in the first trimester can reduce the subsequent occurrence of gestational diabetes mellitus in later trimesters of pregnancy, with a reduction in the adverse maternal and fetal outcomes.