Gestational Diabetes and Hypothyroidism: Do Other Factors Play a Role? A Retrospective Case-Control Study.

Abstract

Background: During pregnancy, extensive hormonal and metabolic changes can occur. Gestational diabetes can cause maternal and neonatal complications. Follow-ups have shown that women who first develop metabolic diseases during pregnancy have an increased risk of developing other metabolic diseases, including hypothyroidism. There are contradictory results. The aim of this study is to provide an overview of the relationship between gestational diabetes and gestational thyroid dysfunctions.

Methods: This study is a retrospective case-control study conducted in 2025 on 353 pregnant women in Iran; 176 were included in the case group (women with gestational diabetes) and 177 in the control group (women without gestational diabetes). The diagnosis of hypothyroidism was assessed in both groups. Descriptive statistics, chi-square test, t-test, and unconditional logistic regression were used to analyze the data.

Findings: Gestational diabetes was associated with a significant increase in the risk of hypothyroidism (approximately 2.8-fold) (p = 0.03). A history of other diseases was also associated with a significantly increased risk of developing hypothyroidism (p = 0.001). In contrast, the risk of hypothyroidism was not significantly associated with age at first pregnancy (p = 0.10), number of pregnancies (p = 0.11), or breastfeeding (p = 0.35).

Conclusion: Gestational diabetes and a history of other diseases significantly increased hypothyroidism risk, while age at first pregnancy, number of pregnancies, and breastfeeding showed no significant associations. Based on these findings, regular thyroid screening is suggested for pregnant women with gestational diabetes or other medical conditions, regardless of reproductive factors.