Thyroid dysfunction prevalence in high-risk pregnant women and maternal and neonatal consequences after delivery: A retrospective cohort study

Objective: To evaluate thyroid dysfunction prevalence and its consequences in high-risk pregnant women and their children. Methods: In this retrospective cohort study, data from high-risk pregnant women who were referred to a governmental referral hospital in Qom, Iran from March to August 2022 were collected. The thyroid disorders were determined according to the 2017 American Thyroid Association guidelines. The predictors of a mother’s hypothyroidism and its fetal and maternal consequences were assessed. Independent t -test, Chi- square test, and logistic regression were used for bivariate and multivariate analysis. Results: 293 women were included. The prevalence of hypothyroidism and hyperthyroidism based on the thyroid stimulating hormone classification was 32.5% and 2.0%. The prevalence of subclinical and overt hypothyroidism was 6.1% and 4.1%, and the prevalence of subclinical and overt hyperthyroidism was 2.4% and 1.4%, respectively. Family history of thyroid disorders was the most important predictor of hypothyroidism during pregnancy ( OR =2.6, 95% Cl =1.0-6.6, P =0.002), while preterm delivery ( OR =2.2, 95% CI =1.3-6.8, P =0.220) and elevated neonate thyroid stimulating hormone ( OR =1.2, 95% CI =1.1-1.3, P =0.041) were the most important consequence of hypothyroidism. Conclusions: Hypothyroidism is a highly prevalent thyroid disorder in high-risk pregnant women. Thyroid function screening should be performed in all pregnant women to increase the detection of subclinical and overt hypothyroidism during pregnancy.