Thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus: a cross-sectional study

Authors

  • Manouchehr Iranparvar Department of Internal Medicine and Endocrinology, Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran
  • Hosein Ghorbani Department of Internal Medicine and Endocrinology, Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran
  • Ahad Azami Department of Internal Medicine, Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran
  • Hosein Darvishkhah Department of Internal Medicine, Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran

DOI:

https://doi.org/10.18203/2349-3933.ijam20151007

Keywords:

Pregnancy, Thyroid dysfunction, Gestational diabetes, Diabetes type 2

Abstract

Background: Objective of current to investigate the relation between Thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes mellitus (GDM).

Methods: This is a cross-sectional descriptive study. In this study, 70 pregnant women in the third trimester of pregnancy with GDM (case group) and 70 healthy pregnant women in the same way (control group) were enrolled. Thyroid function tests (including serum TSH, fT4 level) and anti-TPO auto antibodies were measured in all women. Family history of the diabetes mellitus, GDM and thyroid disease was determined in both groups. Information of all patients was entered in checklists and then analyzed by statistical methods in SPSS.19.

Results: The mean age of patients in case group was 29.98±6.23 and in control group was 28.38 ±6.15. In cases 27.1 % have family history of type 2 diabetes, 2% have history of thyroiditis disorder and 7.1% have history of gestational diabetes. The mean of BMI in cases with 30.52 was more than controls with 29.58. Obtained data showed that TSH level (p=0.033) and anti- TPO (p=0.001) in cases were more than controls and FT4 (p=0.001) level was lower.   

Conclusions: The results showed that thyroid disorders in pregnancy women with gestational diabetes were significantly more than control group. So, doing necessary thyroid function tests as routinely was recommended. 

References

Abalovich M, Amino N, Barbour LA, Cobin RH, De Groot LJ, Glinoer D, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2007;92(8 Suppl):S1-47.

Larsen PR, Davies TF, Schlumberger MJ, Hay ID. Thyroid physiology and diagnostic evaluation of patients with thyroid disorders. In: Kronenberg HM, Melmeds SH, Polonsky KS, Larsen PR. Williams text book of endocrinology. 11th ed. Philadelphia: Saunders Elsevier; 2008: 299-327.

Allan WC, Haddow JE, Palomaki GE, Williams JR, Mitchell ML, Hermos RJ, et al. Maternal thyroid deficiency and pregnancy complications: implications for population screening. J Med Screen. 2000;7(3):127-30.

Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd W, Leveno KJ, et al. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol. 2005;105(2):239-45.

Baker VL, Rone HM, Pasta DJ, Nelson HP, Gvakharia M, Adamson GD. Correlation of thyroid stimulating hormone (TSH) level with pregnancy outcome in women undergoing in vitro fertilization. Am J Obstet Gynecol. 2006;194(6):1668-74.

Prummel MF, Wiersinga WM. Thyroid autoimmunity and miscarriage. Eur J Endocrinol. 2004;150(6):751-5.

Negro R, Formoso G, Mangieri T, Pezzarossa A, Dazzi D, Hassan H. Levothyroxine treatment in euthyroid pregnant women with autoimmune thyroid disease: effects on obstetrical complications. J Clin Endocrinol Metab. 2006;91(7):2587-91.

Gary Cunningham F, Norman F, Kenneth J, Larry C, Johns C, Katharine D. Gestational diabetes mellitus. In: Gary Cunningham F, Norman F, Kenneth J, Larry C, Johns C, Katharine D, eds. Williams Obstetrics. 21th ed. New York: McGraw Hill; 2001: 1359-1379.

American Diabetes Association. Report of the expert committee on the diagnoses and classification of diabetes mellitus. Diabetes Care. 2007;20:1183-97.

Dornhorst A, Patterson CM, Nicholls JS, Wadsworth J, Chiu DC, Elkeles RS, et al. High prevalence of gestational diabetes in women from ethnic minority groups. Diabet Med. 1992;9:820-5.

Jovanovic L. Pathophysiology of diabetes in pregnancy stellite symposium: 36th annual meeting of the European association for the study of diabetes. Jerusalem, Israel: European annual meeting; September 17-21, 2000.

NikooM K, Ahranjani SA. A review on the prevalence of gestational diabetes mellitus (GDM) in different regions of Iran. J Diabetes Metab Disord. 2009;8:47-56 .

Atashzadeh SF. Frequency of gestational diabetes and its related factors in pregnant women in prenatal clinics of educational hospital in Tehran (Oct 2000-March 2002). J Rafsanjan Univ Med Sci Health Serv. 2006;5(3):175-80.

Velkoska Nakova V, Krstevska B, Dimitrovski CH, Simeonova S, Hadzi-Lega M, Serafimoski V. Prevalence of thyroid dysfunction and autoimmunity in pregnant women with gestational diabetes and diabetes type 1. Prilozi. 2010;31(2):51-9.

Vitacolonna E, Lapolla A, Di Nenno B, Passante A, Bucci I, Giuliani C, et al. Gestational diabetes and thyroid autoimmunity. Int J Endocrinol. 2012;2012:867415.

González-Jiménez A, Fernández-Soto ML, Lobón-Hernández JA, López-Medina JA, Navarrete L, Escobar-Jiménez F. Autoimmune thyroid disease and insulin-dependent diabetes mellitus during pregnancy and post-partum. Ann Ist Super Sanita. 1997;33(3):437-9.

Ortega-González C, Liao-Lo A, Ramírez-Peredo J, Cariño N, Lira J, Parra A. Thyroid peroxidase antibodies in Mexican-born healthy pregnant women, in women with type 2 or gestational diabetes mellitus, and in their offspring. Endocr Pract. 2000;6(3):244-8.

Agarwal MM, Dhatt GS, Punnose J, Bishawi B, Zayed R. Thyroid function abnormalities and antithyroid antibody prevalence in pregnant women at high risk for gestational diabetes mellitus. Gynecol Endocrinol. 2006 May;22(5):261-6.

Olivieri A, Magnani F, Valensise H, D’Archivio M, Medda E, Baccarini S, et al. Thyroid autoimmunity in pregnant women at risk for GDM. Ann Ist Super Sanita. 1997;33(3):447-50.

Karakosta P, Alegakis D, Georgiou V, Roumeliotaki T, Fthenou E, Vassilaki M, et al. Thyroid dysfunction and autoantibodies in early pregnancy are associated with increased risk of gestational diabetes and adverse birth outcomes. J Clin Endocrinol Metab. 2012;97(12):4464-72.

Kruś J, Szymański W, Korbal P. Thyroid dysfunction in pregnant women and correlation with clinical and metabolical status of their newborns. Ginekol Pol. 2003;74(10):1166-72.

Lercher-Hartlieb A, Kainer F, Pertl B, Winter R. Thyroid gland function in pregnant diabetic patients. Acta Med Austriaca. 1997;24(4):144-5.

Montaner P, Juan L, Campos R, Gil L, Corcoy R. Is thyroid autoimmunity associated with gestational diabetes mellitus? Metabolism. 2008;57(4):522-5.

Downloads

Published

2017-01-22

Issue

Section

Original Research Articles