Diagnosis and Management of Subclinical Hypothyroidism in Pregnancy: A Retrospective Review Study

Abstract

Back ground: The hormones of thyroid organ play an important role for a normal pregnancy without maternal or fetal complexities. However, using different methods and thyrotropin (TSR) ranges for diagnosis subclinical hypothyroidism (SCH) in different population are challenging. The aim of this study is to clarify the world wide variation in prevalence of SCH, the accurate methods been used for diagnosing (SCH) in pregnant women, main adverse pregnancy outcomes related to (SCH) and the clinical impact of levothyroxine on gestational SCH related complications. Methods: Meta-analysis of the results of all studies that were investigated the screening methods, adverse pregnancy outcomes and the treatment of SCH during pregnancy which was published in English language during the last two decade including the popular guidelines in this regard. Results: The studies revealed a strong linear association between preterm delivery, miscarriage and TSH level with more events, if combined with positive thyroid antibodies. The difference in TSH (TSR) ranges among different ethnicity and countries should be considered for diagnosis and treatment. Conclusion: Early diagnosis and treatment of SCH during pregnancy is cost effective in reducing the preterm labour, miscarriage and its complications. Using specific TSH cut off level for each population is essential for accurate diagnosis and screening should include not only high risk cases but patients in countries with high prevalence of SCH.