Effect of thyroid autoimmunity on pregnancy outcomes in gestational diabetes mellitus

Ramya Varada, Mythili Ayyagari, Vivekanand Bongi, Jayanthy Ramesh, K A V Subrahmanyam

Thyroid Research and Practice 2018 15(2):80-83

Context: There are little data on the prevalence of thyroid autoimmunity in gestational diabetes mellitus (GDM) and its influence on pregnancy outcomes. Aims: The aims were to estimate the prevalence of thyroid autoimmunity in euthyroid GDM and to compare the pregnancy outcomes in euthyroid antithyroid peroxidase antibody (TPOAb)-positive women to TPOAb-negative women and to compare the pregnancy outcomes across the euthyroid range of thyroid-stimulating hormone (TSH). Design: This is an observational, prospective cohort study. Subjects and Methods: One hundred women with GDM with euthyroid status were recruited. Samples were analyzed for TSH, free T4, and TPOAb. Women with TPOAb positivity were considered as cases and with TPOAb negativity were controls. Pregnancy outcomes assessed were pregnancy-induced hypertension (PIH), preterm delivery, cesarean section, birth weight, birth asphyxia, neonatal jaundice, hypoglycemia, seizures, and stillbirths. Statistical Analysis: Student t-test and Chi-square test were used to compare the mean values between the groups and differences between proportions, respectively, and P < 0.05 was considered statistically significant. Results: The prevalence of TPOAb positivity in euthyroid GDM was 14%. Pregnancy outcomes between cases and controls were similar except for neonatal jaundice (42.9% vs. 18.5%), which was statistically significant (P = 0.04). PIH occurred in 28.6% and 25.6% in cases and controls, respectively. There was no significant difference in maternal and neonatal outcomes across euthyroid range of TSH. Conclusion: The prevalence of TPOAb positivity in euthyroid GDM was similar to the nondiabetic pregnant women. Neonatal jaundice was more in TPOAb-positive women. Pregnancy outcomes were comparable across the euthyroid range in GDM, suggesting similar range as those without GDM. There is no influence of thyroid autoimmunity on pregnancy outcomes in GDM in the present study.

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