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Original scientific paper

https://doi.org/10.20471/acc.2021.60.02.10

Isolated Maternal Hypothyroxinemia and Its Perinatal Outcome in North Macedonia

Maja Avramovska orcid id orcid.org/0000-0003-1129-1205 ; Dr. Trifun Panovski Clinical Hospital, Bitola, North Macedonia
Borislav Karanfilski ; National Committee for Iodine Deficiency, Ministry of Health, Skopje, North Macedonia
Goran Dimitrov ; Department of Gynecology and Obstetrics, Faculty of Medicine, Ss. Cyril and Methodius University of Skopje, Skopje, North Macedonia
Elena Dzikova ; Department of Gynecology and Obstetrics, Faculty of Medicine, Ss. Cyril and Methodius University of Skopje, Skopje, North Macedonia
Ana Daneva Markova ; Department of Gynecology and Obstetrics, Faculty of Medicine, Ss. Cyril and Methodius University of Skopje, Skopje, North Macedonia
Marija Hadzi Lega ; Danat al Emarat Hospital for Women and Children, Abu Dhabi, Emirate of Abu Dhabi
Gligor Tofoski ; Department of Gynecology and Obstetrics, Faculty of Medicine, Ss. Cyril and Methodius University of Skopje, Skopje, North Macedonia
Aleksandar Sikole ; Department of Nephrology, Faculty of Medicine, Ss. Cyril and Methodius University of Skopje, Skopje, North Macedonia


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Abstract

Isolated maternal hypothyroxinemia (IMH) is defined as the presence of low
maternal total thyroxine (TT4) level in conjunction with normal maternal thyroid-stimulating
hormone
(TSH) level. The aim was to investigate whether IMH is associated with adverse pregnancy
outcome in North Macedonia. Dried blood spot samples were obtained from 359 pregnant women
meeting the inclusion criteria and analyzed for TT4 and TSH. Postpartum data were entered from
their medical histories. Out of 359 women, 131 (37.42%) belonged to IMH group. There were statistically
significant differences in birth weight (p=0.043), intrauterine growth restriction (IUGR)
(p=0.028), Apgar score at 1 min <7 (p=0.018) and cesarean section for dystocia/disproportion
(p=0.024) between the IMH and normal thyroid function (NTF) groups. In regression analysis,
TSH was a significant variable predicting Apgar score (βst=0.05597, p=0.047), body mass index
predicting
birth weight (βst=0.02338, p=0.045) and TT4 predicting small for gestational age/IUGR
(βst=-0.089834, p=0.029) in IMH group. TT4 was a strong predictor of birth weight (βst=-0.004778,
p=0.003) and premature delivery (βst=0.028112, p=0.004) in NTF group. The impact of IMH in
pregnancy remains controversial. IMH was associated with an increased maternal BMI and higher
birth weight of neonates. Overweight could be a potential risk factor for thyroid dysfunction in pregnant
women, and specifically IMH. The worst fetal outcome was seen in IMH mothers examined in
second trimester. We found TSH, TT4 and BMI to be strong predictors of perinatal outcomes.

Keywords

Isolated hypothyroxinemia, Perinatal outcome, Low birth weight, Preterm birth, Obesity

Hrčak ID:

263490

URI

https://hrcak.srce.hr/263490

Article data in other languages: croatian

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