Comparison of American Thyroid Association and Conventional Criteria in Diagnosing Hypothyroidism among Pregnant Ladies Attending a Tertiary Care Hospital

A BSTRACT Background: There is continuing debate regarding universal screening, the use of a thyroid-stimulating hormone (TSH) cutoff value, and levothyroxine replacement in frequently encountered issues like subclinical hypothyroidism in pregnancy. The study was intended to compare the American Thyroid Association (ATA)-2011 defined trimester-specific TSH with conventional TSH values in the diagnosis of newly detected hypothyroidism in pregnancy, as there are no trimester-specific reference ranges of TSH in Bangladesh. Methods: This cross-sectional, observational study enrolled 175 pregnant women recruited by convenient sampling from the Department of Obstetrics and Gynecology, BIRDEM General Hospital. As per the study protocol, investigations were advised. TSH, free thyroxine, and antithyroid antibodies were tested using the chemiluminescent technique. Data were analyzed by SPSS version 25. Nonparametric tests were chosen for statistical analysis. Results: The majority (53%) of the participants, were 30 years of age or younger. Using the ATA-2011 defined trimester-specific reference ranges of TSH, 32% had hypothyroidism. While using the conventional criteria (TSH – 0.4–4 mIU/L), hypothyroidism was diagnosed in 20.6% of cases. Conclusions: There is statistically significant discordance in diagnosing hypothyroidism in pregnancy between the two criteria.