Publication:

Association of subclinical thyroid disorder in hypertensive pregnant women attending a tertiary care hospital

Background Subclinical thyroid disorders have gained increasing attention because thyroid hormones play an important role in cardiovascular function and blood pressure regulation, and pregnancy-related physiological changes further complicate the assessment of thyroid function. The purpose of the present study was to evaluate the association between subclinical thyroid disorder and hypertension in pregnant women attending a tertiary care hospital.

Methods This cross-sectional comparative study at the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh (Feb 2020–Mar 2021), included 220 pregnant women (110 hypertensive, 110 normotensive) matched for age, parity, and gestational age. Socio-demographic, obstetric, and clinical data were collected, blood pressure measured, and serum TSH and FT4 analyzed using Siemens ADVIA Centaur XP CLIA with ATA trimester-specific ranges. Data were analyzed with SPSS 25 (p <0.05).

Results Among 220 pregnant women (110 hypertensive, 110 normotensive), most were 18–25 years, 29–40 weeks gestation, and nulliparous, with no significant differences. Pre-eclampsia with severe features was most common (40%). Subclinical hypothyroidism was higher in hypertensive women (46.4% vs 14.5%, p=0.001) and associated with elevated BP. Hypertensive women had higher TSH (4.46 vs 2.28 µIU/ml) and lower FT4 (13.49 vs 15.78 pmol/l), most pronounced in pre-eclampsia (p≤0.001).

Conclusions Subclinical hypothyroidism is the most common thyroid disorder in hypertensive pregnant women and is associated with higher blood pressure, suggesting early detection may help reduce the severity of pregnancy-related hypertension.