PROGNOSTIC RISK OF OBSTETRIC AND PERINATAL COMPLICATIONS IN PREGNANT WOMEN WITH THYROID DYSFUNCTION

Maternal thyroid pathology takes important role in obstetric and peri-neonatal morbidity structure. Despite of the number of studies conducted in the field of thyroid disorders of pregnant females, the definition of influence of thyroid gland dysfunction on maternal and neonatal health still remains actual. The mentioned topics draw specific interest in the aspect of prognosticaiton of complications and unfavorable outcome. Aim of the study - to define the specificities of gestation period and determine the prognostic risk of obstetric and perinatal complications in pregnant females with thyroid pathology. The study was performed at the base of "David Gagua Clinic" Ltd. Prospective, open controlled study design was applied. Based upon the referral to the clinic, 292 pregnant females with thyroid pathology were involved in the main group. The control group involved 58 conditionally healthy pregnant females of reproductive age. Thyroid status had been monitored accoding to trimesters during the whole period of prgnancy and 1 month following the delivery. The health state of neonates was assessed by international protocols. To define the confidence interval for relative ratio between quantitative data of compared groups, c2 , P and RR indices were calculated, and its critical level was considered to be 0.05. The risks ratio with defining of the data was determined for obstetric and perinatal complications. 120 (41.4%) of pregnant subjects demonstrated hypothyroidism, 104 (35.6%) - isolated hypothyroxinmia, and 13 (4.5%) - hyperthyroidism. High levels of anti-thyroid peroxidase antibodies were observed in 54 (18.5%) of cases, nodular gout was found in 38 (13%) patients, 5 (12.3%) of which was associated with hypothyroidism and 9 (23%) - with isolated hypothyroxinemia. Correcting treatment was administered to all pregnant subjects during the pregnancy period. Based on the analysis of acquired data, the high probability of prengancy-related nausea/vomiting and iron-deficiency anemia was demonstrated in the population of pregnant females with thyroid pathology, especially in those with hypothyroidism and isolated hypothyroxinemia. The prognostic risk of early spontaneous abortion, premature delivery and obstetric surgical interventions was statistically significant in pregnant females with hypothyroidism. The relative ratio for low neonatal weight, maternal iron deficiency anemia in postpartum period, abnormal weight gain and chronic lower limb venous disorders were high in the aspect of perinatal outcomes. Thus, despite of timely diagnosis and adequate treatment, thyroid pathology revealed in the gestational period is related with particular risk for development of obstetric and perinatal complications, which indicates on absolute necessity of pregravid preparation and achievement of euthyroid state at preliminary stage of pregnancy planning.