Hypothyroid presentation and TSH screening in pregnant women visiting National Guard Health Affairs antenatal clinics

Researcher: DR. FARES ALKAHTANI

National Guard Program – Riyadh  2012/2013

Background: hypothyroidism is not an uncommon endocrine disease in pregnant women in KSA. There are multiple adverse outcomes to the pregnant women and their babies which can be prevented by TSH screening in first antenatal care.

Objectives: the aim of study was to explore the prevalence of hypothyroid symptoms among pregnant ladies visiting antenatal and using TSH as screening test.

 Subjects and methods: Cross-sectional study was carried out among 500 pregnant women who followed up in antenatal care clinics in NGHA Riyadh during November 2013 and February 2014. Data were collected using a self-administered questionnaire adopted from American Thyroid Association, translated and modified to be suitable for local population. Descriptive analysis was carried out and Chi-square test with P-value were used to explore for cut-off levels of TSH levels of 2.5, 3 and 4 mlU/L.

 Results :Most pregnant women in the sampled population were in second trimester (62.9%) and others in first trimester (36.3%) with mean age 29.6 years and mean TSH level 2.22 mlU/L. The prevalence of high TSH level was noted to be high among the participants; for TSH level ≥2.5 mlU/L it was (32.2%), in TSH level ≥3 mlU/L, it was (20.2%) and in TSH level ≥4 mlU/L it was (6.6%). The study also showed that participants with TSH level ≥4 mlU/L were most likely to be in second trimester (Chi-sq = 5.19, p-value 0.023), Odds Ratio 2.75 (95% CI 1.11- 6.80). There is no symptom can be statistically significant in TSH level 2.5 or 3. Constipation was the only symptoms which was significant at TSH level ≥4 mlU/L (Chi-sq = 4.25, p-value 0.039). The study show no relationship between TSH level and the total number of hypothyroid symptoms present.

 Conclusion: This study showed high prevalence of elevated TSH levels among pregnant ladies visiting NGHA antenatal clinics and It warrants further studies with universal screen testing with TSH during pregnancy in the local region to estimate prevalence of subclinical or clinical hypothyroidism.

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