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MATERNAL FETAL FEATURES IN A GROUP OF PREGNANT WOMEN DIAGNOSED WITH CHRONIC AUTOIMMUNE THYROIDITIS AND VITAMIN D DEFICIENCY
Abstract
Objective of the study Identification of maternal-fetal outcome in women with chronic autoimmune thyroiditis associated with vitamin D deficiency during pregnancy and postpartum. Material and methods: The study included a group of 36 pregnant women diagnosed with chronic autoimmune thyroiditis and normal thyroid function. Patients were monitorized starting with the first trimester of pregnancy and postpartum. In the first trimester, the serum levels of TSH, FT4, antithyroperoxidase antibodies (TPOAb) and antithyroglobulin antibodies (TGAb.) were dosed. The values of constants measured in the first trimester were compared with the values obtained in the third trimester and were supplemented with the dosage of 25- (OH) -vitamin D level. Based on the values obtained, the pregnant women were divided into two groups: group 1 = vitamin D 30 ng / ml. Materno-neonatal outcomes analysed were: maternal miscarriage risk, premature birth and neonatal - birth weight, respiratory distress, neonatal hypothyroidism. Results: In the group of pregnants that associated vitamin D deficiency (67%) compared to pregnants with normal vitamin D level (33%) (p <0.001), the data showed an increased incidence of both maternal and fetal complications. Differences of moderate statistical significance (p <0.05) were observed for TSH serum compared in the first / third trimester for each study group, although TSH mean values had a rising trend in both groups in the third trimester. Antithyroid antibodies recorded a significant increase (p <0.001) in serum compared to I/III trimester for TPOAb in group 2 and for TGAb in group 1. Statistical differences between groups were recorded in the first trimester for TPOAb (p < 0.03). Maternal-neonatal outcome shows a significant incidence in favor of the group with vitamin D deficiency: miscarriage risk (25%: 8.3%, RR = 3.01); respiratory distress (12.5: 8.3%; RR = 1.5); mean newborn weight (2747: 3410g; p <0.005). Consumption of nutritional supplements during pregnancy was more common in group 2 (58.3%) than in group 1 (45.8%); Conclusions: Involvement of low vitamin D levels in chronic autoimmune thyroiditis with normal thyroid function appears to be likely to have an effect in materno - neonatal outcomes during pregnancy and postpartum. The low percentage of pregnant women consuming vitamin supplements in pregnancy poses problems of compliance and nutritional quality of supplements. The identification of vitamin D deficiency in the third trimester of pregnancy recommends including its determination in prenatal screening and during pregnancy as weel.
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