The Biobrio 12(1 & 2), 2025

Maternal thyroid function during pregnancy as sero-diagnostic marker of pregnancy, delivery and birth outcome

Abhishek Mitra, Hasib Ansari, Birendra Kumar Gupta, Ajay Kumar Sharma & Mohammad Sohail

ABSTRACT:

The burden of infection during pregnancy is of public health concern across the globe, in view of the pathogenesis, hormonal alterations, clinical sequelae, prevention and treatment of infections; all have unique features during pregnancy. The combinatorial effect of infection/s, physiological, metabolic alterations and various other obstetric complications during human pregnancy further complicates the prompt and accurate diagnosis of hormonal alterations and infections. This prompted us to investigate the prevalence of infections, haematological perturbations and the role of maternal thyroid function as reliable biochemical marker for diagnostic potential in pregnancy and delivery. Between September 2021 and December 2022, 1715 and 870 women at ANC and DU were enrolled, and screened for malaria by microscopy and RDT. Anaemia was defined as haemoglobin concentration. Thyroid function tests were measured in six stratified groups from ANC and two from DU using competitive ELISA kit. The prevalence of malaria during pregnancy was 5.4% and 4.3% at ANC and DU, respectively and 13.2% in non-pregnant women with malaria, majority of which were infected with P. vivax. Anaemia was significantly associated with malaria; however, severe anaemia was more common among women with parasitaemia. Further, observed gestational age specific increasing trend of TSH concentration and differences were significant for all the trimesters as compared to healthy women. TSH were significantly higher in infection as compared to healthy women and those with malaria without pregnancy. The TSH concentrations were highest in caesarean and still birth & higher in normal mode of delivery as compared to healthy women, whereas marginally elevated in caesarean and still birth as compared to normal delivery. Pre-term delivery had highest TSH followed by post-term and term delivery; whereas compared to term delivery, TSH was higher in pre-term and post-term delivery. High prevalence of infection in women and in pregnant women with associated anaemia suggests prompt diagnosis regardless of symptoms and comprehensive drug regime to be offered. Further, thyroid function evaluation could be considered to be reliable prognostic markers and possess promising rationale for diagnostic potential in association with existing measures in clinical spectrum of infection, pregnancy, delivery and its outcome.

Keywords:    

TSH, Delivery, Birth-Outcome, Diagnostic Marker, Pregnancy

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