Association of Hypothyroidism and Anti-thyroid Antibodies with Preterm Delivery.

Abstract

Preterm delivery is an important risk factor for child mortality and psychiatric, metabolic and cardiovascular disease later in life. In most of the cases, the cause of prematurity remains unidentified. There is still ongoing debate about whether abnormal maternal thyroid function during pregnancy contributes to a higher risk of preterm birth. This study aimed to examine the relationship between hypothyroidism, the presence of anti-thyroid antibodies and preterm delivery. This cross-sectional analytic study was conducted in the Department of Obstetrics and Gynaecology at Dhaka Medical College Hospital (DMCH), Bangladesh from June 2022 to May 2023. Two hundred patients were enrolled in this study obeying exclusion and inclusion criteria. Purposive sampling method was used for the selection of respondent. Both preterm and term labor was diagnosed clinically. Gestational age was established based on LMP and early dated ultrasonography. Estimation of maternal thyroid stimulating hormone (Serum TSH) was done by Immuno-radiometric assay and anti-thyroperoxidase antibody (Anti-TPO) by Siemens ADVIA Centaur XPT Chemiluminescence Immunoassay methods. Relevant data was collected in a predesigned questionnaire. Among women who experienced preterm delivery, 27.0% were found to have hypothyroidism, whereas only 12.0% of those who delivered at term had this condition. Anti-TPO antibody positivity was observed in 16.0% of the preterm group compared with 7.0% of the term delivery group. Both the prevalence of hypothyroidism and anti-TPO antibody positivity were significantly higher in the preterm delivery group, with the differences reaching statistical significance (p<0.05). But this significant association was with very early preterm group not with moderate preterm delivery. Hypothyroidism had effect on preterm delivery rates, but had significant association with very early preterm delivery. The existence of anti-TPO antibodies in the serum had a significant increasing effect on preterm deliveries and could be regarded as risk factor.