MATERNAL HYPOTHYROIDISM AND ITS ASSOCIATION WITH ADVERSE OBSTETRIC AND NEONATAL OUTCOMES: A CROSS-SECTIONAL STUDY FROM MARDAN, PAKISTAN

Abstract

Objective:
To determine the frequency of hypothyroidism and its association with selected obstetric and perinatal morbidities among women admitted for delivery at a tertiary care hospital.

Study Design and Setting:

Hospital-based cross-sectional study conducted in the Department of Obstetrics and Gynaecology at Mardan Medical Complex, Mardan, Khyber Pakhtunkhwa, Pakistan.

Methodology:
A total of 400 pregnant women aged 18–45 years with singleton pregnancies admitted for delivery were enrolled using non-probability consecutive sampling over a one-year period from 1st January 2024 to 31st December 2024. Thyroid function tests were performed at admission. Based on serum thyroid-stimulating hormone and free thyroxine levels, participants were classified as euthyroid, subclinical hypothyroid, or overt hypothyroid. Obstetric outcomes included preeclampsia, preterm delivery, and mode of delivery, while perinatal outcomes included low birth weight, neonatal intensive care unit admission, and neonatal mortality. Data were analyzed using SPSS version 25, and a p-value <0.05 was considered statistically significant.

Results:
Among 400 women, 287 (71.8%) were euthyroid and 113 (28.2%) had hypothyroidism, including 97 (24.3%) subclinical and 16 (4.0%) overt cases. No significant association was found between hypothyroidism and preeclampsia (p = 0.274), preterm delivery (p = 0.301), cesarean section (p = 0.819), low birth weight (p = 0.392), NICU admission (p = 0.926), or neonatal mortality (p = 0.279).

Conclusion:
Hypothyroidism, particularly subclinical hypothyroidism, is relatively common among women admitted for delivery. However, it was not significantly associated with major obstetric or perinatal morbidity. These findings highlight the need for improved antenatal screening and early detection of thyroid dysfunction.