Keywords
pregnancy
risk factors
diagnosis
prevalence
thyroid
How to Cite
Abstract
Objective: To establish the prevalence of hypothyroidism in a population of pregnant women in the coffee region (Colombia).
Methods: Observational, descriptive cross-section study. Pregnant women of first admission to prenatal control were included. All pregnant women underwent the thyroid profile test based on the recommendations of the American Thyroid Association. We included pregnant women of legal age, with a single pregnancy, with electronic medical records, without pre-existing thyroid disease who agreed to participate in the study. Pregnant women with neoplastic or hematological disease, chronic renal insufficiency or with congenital fetal abnormalities were excluded. The study was carried out in three tertiary care centers of the coffee region between 2014 and 2017. A consecutive systematic random sampling was carried out. Socio-demographic variables, hypothyroidism symptoms and sexual and reproductive health antecedents were measured. A descriptive analysis of the information was made using absolute and relative frequency measurements.
Results: of a total of 579 women selected to participate, 467 (80.65%) were finally analyzed. The average age was 24.85 (SD ± 5.3) years. The prevalence of hypothyroidism in the studied group was 38.75 % (n = 181/479), 22.69 % (n = 106) with clinical hypothyroidism, 15.99 % (n = 75) subclinical hypothyroidism and 12.41 % (n = 58) presented an autoimmune thyroid disorder.
Conclusion: The pregnant women of the Coffee Region have a high prevalence of hypothyroidism, being higher than reported in other areas of the world. It is necessary to promote timely interventions to establish an early diagnosis and appropriate treatment.
References
2. Negro R, Mestman JH. Thyroid disease in pregnancy. Best Pract Res Clin Endocrinol Metab. 2011;25(6):927-43.
3. Lazarus J, Brown RS, Daumerie C, Hubalewska-Dydejczyk A, Negro R, Vaidya B. 2014 European thyroid association guidelines for the management of subclinical hypothyroidism in pregnancy and in children. Eur Thyroid J. junio de 2014;3(2):76-94.
4. Negro R, Schwartz A, Gismondi R, Tinelli A, Mangieri T, Stagnaro-Green A. Increased pregnancy loss rate in thyroid antibody negative women with TSH levels between 2.5 and 5.0 in the first trimester of pregnancy. J Clin Endocrinol Metab. 2010;95(9):E44-48.
5. De Groot L, Abalovich M, Alexander EK, Amino N, Barbour L, Cobin RH, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2012;97(8):2543-65.
6. Rashid M, Rashid MH. Obstetric Management of Thyroid Disease: Obstet Gynecol Surv. 2007;62(10):680-8.
7. Casey BM, Dashe JS, Spong CY, McIntire DD, Leveno KJ, Cunningham GF. Perinatal Significance of Isolated Maternal Hypothyroxinemia Identified in the First Half of Pregnancy: Obstet Gynecol. 2007;109(5):1129-35.
8. Cleary-Goldman J, Malone FD, Lambert-Messerlian G, Sullivan L, Canick J, Porter TF, et al. Maternal thyroid hypofunction and pregnancy outcome. Obstet Gynecol. 2008;112(1):85-92.
9. Lazarus JH, Bestwick JP, Channon S, Paradice R, Maina A, Rees R, et al. Antenatal Thyroid Screening and Childhood Cognitive Function. N Engl J Med. 2012;366(6):493-501.
10. Potlukova E, Potluka O, Jiskra J, Limanova Z, Telicka Z, Bartakova J, et al. Is age a risk factor for hypothyroidism in pregnancy? An analysis of 5223 pregnant women. J Clin Endocrinol Metab. 2012;97(6):1945-52.
11. Allan WC, Haddow JE, Palomaki GE, Williams JR, Mitchell ML, Hermos RJ, et al. Maternal thyroid deficiency and pregnancy complications: implications for population screening. J Med Screen. 2000;7(3):127-30.
12. Blatt AJ, Nakamoto JM, Kaufman HW. National status of testing for hypothyroidism during pregnancy and postpartum. J Clin Endocrinol Metab. 2012;97(3):777-84.
13. Glinoer D. Pregnancy and Iodine. Thyroid. 2001;11(5):471-81.
14. Fitzpatrick DL, Russell MA. Diagnosis and management of thyroid disease in pregnancy. Obstet Gynecol Clin North Am. 2010;37(2):173-93.
15. Granfors M, Åkerud H, Berglund A, Skogö J, Sundström-Poromaa I, Wikström A-K. Thyroid testing and management of hypothyroidism during pregnancy: a population-based study. J Clin Endocrinol Metab. 2013;98(7):2687-92.
16. Amouzegar A, Ainy E, Khazan M, Mehran L, Hedayati M, Azizi F. Local versus international recommended TSH references in the assessment of thyroid function during pregnancy. Horm Metab Res Horm Stoffwechselforschung Horm Metab. 2014;46(3):206-10.
17. Pearce SHS, Brabant G, Duntas LH, Monzani F, Peeters RP, Razvi S, et al. 2013 ETA Guideline: Management of Subclinical Hypothyroidism. Eur Thyroid J. 2013;2(4):215-28.
18. Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, et al. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid Off J Am Thyroid Assoc. 2017;27(3):315-89.
19. Klein RZ, Haddow JE, Faix JD, Brown RS, Hermos RJ, Pulkkinen A, et al. Prevalence of thyroid deficiency in pregnant women. Clin Endocrinol (Oxf). 1991;35(1):41-6.
20. Nambiar V, Jagtap VS, Sarathi V, Lila AR, Kamalanathan S, Bandgar TR, et al. Prevalence and Impact of Thyroid Disorders on Maternal Outcome in Asian-Indian Pregnant Women. J Thyroid Res. 2011;2011:1-6.
21. Fukushi M, Honma K, Fujita K. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med. 1999;341(26):2016; author reply 2017.
22. Wang W, Teng W, Shan Z, Wang S, Li J, Zhu L, et al. The prevalence of thyroid disorders during early pregnancy in China: the benefits of universal screening in the first trimester of pregnancy. Eur J Endocrinol. 2011;164(2):263-8.
23. Bocos-Terraz JP, Izquierdo-Álvarez S, Bancalero-Flores JL, Álvarez-Lahuerta R, Aznar-Sauca A, Real-López E, et al. Thyroid hormones according to gestational age in pregnant Spanish women. BMC Res Notes. 2009;2:237.
24. Abalovich M, Gutierrez S, Alcaraz G, Maccallini G, Garcia A, Levalle O. Overt and Subclinical Hypothyroidism Complicating Pregnancy. Thyroid. 2002;12(1):63-8.
25. Casey BM, Leveno KJ. Thyroid disease in pregnancy. Obstet Gynecol. 2006;108(5):1283-92.
26. Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd W, Leveno KJ, et al. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol. 2005;105(2):239-45.
27. Alexander EK, Marqusee E, Lawrence J, Jarolim P, Fischer GA, Larsen PR. Timing and magnitude of increases in levothyroxine requirements during pregnancy in women with hypothyroidism. N Engl J Med. 2004;351(3):241-9.
28. Henrichs J, Bongers-Schokking JJ, Schenk JJ, Ghassabian A, Schmidt HG, Visser TJ, et al. Maternal thyroid function during early pregnancy and cognitive functioning in early childhood: the generation R study. J Clin Endocrinol Metab. 2010;95(9):4227-34.
29. Morreale de Escobar G, Obregon MJ, Escobar del Rey F. Role of thyroid hormone during early brain development. Eur J Endocrinol. 2004;151 Suppl 3:U25-37.
30. Glinoer D, Soto MF, Bourdoux P, Lejeune B, Delange F, Lemone M, et al. Pregnancy in Patients with Mild Thyroid Abnormalities: Maternal and Neonatal Repercussions*. J Clin Endocrinol Metab. agosto de 1991;73(2):421-7.
Authors must state that they reviewed, validated and approved the manuscript's publication. Moreover, they must sign a model release that should be sent. A copy may be reviewed here