Thyroid dysfunction is a worldwide phenomenon in women, and the prevalence
increases during pregnancy, with hypothyroidism being the most common.
In most developing countries, nutritional deficiencies of nearly all essential
nutrients, including iron, vitamin B12, and folic acid, are common in pregnant
women. Thyroid disorders and nutritional deficiencies especially of iron and vitamin
B12 cause a number of maternofetal complications.
Objectives
To assess thyroid status in pregnant Saudi women and explore its relation to ferritin
and vitamin B12.
Patients and methods
This was a cross-sectional study conducted at antenatal clinics of the Northern Area
Armed Forces Hospital, KSA, enrolling 254 Saudi women: 180 pregnant [classified
according to gestational age into group A (first trimester) and group B (second
trimester)], and 74 age-matched healthy nonpregnant women, as control group
(group C). After a detailed obstetrical and medical history, and clinical assessment,
participants were subjected to laboratory investigations in the form of thyroid
function by measuring thyroid-stimulating hormone (TSH) and free thyroxin,
hemoglobin (HB), serum ferritin, and vitamin B12 levels.
Results
TSH level was lower in pregnant than nonpregnant women. Subclinical
hypothyroidism (35.5%) was the most common thyroid disorder followed by
overt hypothyroidism (10%) and hypothyroxinemia (2.2%) in pregnant women.
HB and vitamin B12 levels were significantly lower in first and second trimesters of
pregnancy when compared with controls (P=0.001). Serum free thyroxin correlated
positively with HB and ferritin, whereas TSH correlated negatively with HB and
ferritin.
Conclusion
High prevalence of hypothyroidism in pregnant females and its association with iron
and vitamin B12 deficiencies highlight the urgent need for thyroid status to be
detected and to evaluate nutritional deficiencies in such group, so as to start early
treatment promptly and to prevent the adverse effects of the disorder to both mother
and fetus to achieve normal pregnancy outcome. |
