Fetal cardiac left ventricle functional changes in pregnancies with maternal hypothyroidism

To evaluate fetal cardiac function in cases with overt and subclinical hypothyroidism and to determine the effect of levothyroxine (LT4) treatment and Anti-thyroid peroxidase (Anti-TPO) antibody status on fetal cardiac functions in cases with subclinical hypothyroidism.

Within the scope of the study, fetuses of 23 overt hypothyroid, 52 subclinical hypothyroid and 250 control group pregnant women were evaluated. Fetal cardiac function was assessed via cardiac Doppler.

Isovolumetric relaxation time (IRT) and myocardial performance index (MPI) values in the overt hypothyroid group were significantly higher than both the subclinical hypothyroid group (p: .006, p: .000, respectively) and the control group (p: .000, p: .000, respectively). In addition, both IRT and MPI were significantly higher in the subclinical hypothyroid group than in the control group (p: .000, p: .000, respectively). In the subclinical hypothyroid group, there was no significant difference in terms of cardiac function parameters in the fetuses of pregnant women who received LT4 therapy and those who did not. When pregnant women with subclinical hypothyroidism were evaluated according to their Anti-TPO antibody status, IRT and MPI values were found to be significantly higher in fetuses of Anti-TPO (+) pregnant women (respectively, p: .005, p: .019).

In the presence of maternal overt or subclinical hypothyroidism, fetal cardiac functions may be affected as early as the second trimester. Anti-TPO antibody positivity in cases with subclinical hypothyroidism seems to negatively affect fetal cardiac functions.