Research Proposal on PREGNANCY OUTCOME IN THYROID DISORDERS
Thyroid disorders are common in women during pregnancy. Excess or deficiency of maternal thyroid hormones may be associated with adverse health outcomes for both mother and child (1). Thyroid dysfunction has varied impact on pregnancy outcome (2).The most frequent thyroid disorder in pregnancy is maternal hypothyroidism and it is associated with fetal loss, placental abruption, pre-eclampsia, preterm delivery and reduced intellectual function in the offspring (3). Subclinical hypothyroidism (SCH) is associated with increased risk of adverse pregnancy outcomes and with an increased risk of neurocognitive deficits in the developing fetus (4). Poor control of thyrotoxicosis is associated with miscarriages, pregnancy induced hypertension, prematurity, low birth weight (LBW), intrauterine death (IUD), stillbirth, thyroid storm and maternal congestive heart failure (4). Subclinical hyperthyroidism is not associated with adverse pregnancy outcomes (5). The presence of antibodies to thyroid peroxidase (TPO-Ab) has been associated with increased risk of miscarriage, pre-term birth and maternal post partum thyroid disease (6). Overt hypothyroidism is seen in 3% cases, while 5% as having SCH, clinical hyperthyroidism is 3.5% and sub-clinical hyperthyroidism is 4% (7). About 10% of pregnant women have positive anti TPO antibodies (8). Other problems of thyroid disorders in pregnancy are post partum thyroiditis, thyroid nodules, and cancer, hyperemesis graviderum etc. (9). Thyroid dysfunction has marked preference in reproductive age group, of which 20—25% may be affected (10).
This study is undertaken in order to determine the effect on pregnancy outcome of thyroid function disorders in Bangladeshi pregnant mothers attending outpatient departments of Endocrinology and Obstetrics & Gynecology of BSMMU, Shahbag, Dhaka on referral basis.