Evaluation of Thyroid Functional Disorders in Preeclampsia Patients

Document Type : Original Article


1 Associate Professor of Obstetrics and Gynecology.Department of Obstet and Gynecol, Obstetrics and Gynecology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

2 Assistant Professor of Obstetrics and Gynecology.Department of Obstetrics and Gynecology, Member of the Student Research Committee, Fetus Fertility and Infertility Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

3 Associate Professor of Diabetes and Endocrinology.Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

4 Resident of Obstetrics and Gynecology,Department of Obstetrics and Gynecology, Member of the Student Research Committee, Fetus Fertility and Fertility Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.


Background and Objective: Preeclampsia is a multiple system disorder characterized by blood pressure and protein deficiency in the second half of pregnancy. Several factors, such as genetic and environmental factors, are involved in the onset of this disorder. Considering the results from a survey conducted and the possibility of increased risk of thyroid disorders in mothers with preeclampsia, this study evaluated the level of thyroid dysfunction in patients with preeclampsia.
Subjects and Methods: This study was a cross-sectional study which was conducted on 79 pregnant women with pre-eclampsia and 79 healthy pregnant women admitted to Imam Khomeini Hospital, Ahvaz. Sampling was performed using a sequential non-probability sampling method. At the end of the study, data were analyzed using descriptive statistics (mean and percentage) and analytical statistics (independent T-test) or its nonparametric equivalent methods.
Results: The mean age of the patient group was 28.4 ± 6.5 y and in the healthy group was 29.3 ±6 y. The mean of gestational age in the patient group was 258.8 ± 22.3 y and 254.5 ± 22.7 y in the healthy group. Analysis shows that there was no significant difference between the levels of thyroid hormones in both groups. Statistical analysis showed patients with normal pregnancy and pre-eclampsia had significantly higher anti-TPO than healthy group (P<0.001).
Conclusion: According to these results, the incidence of preeclampsia can exacerbate the level of thyroid disorders, but this does not seem to be statistically significant. Therefore, mothers who are at risk for preeclampsia should be monitored for thyroid function and should be treated appropriately if necessary, to prevent the exacerbation of this dangerous condition.


1-Irgens HU, Roberts JM, Reisæter L, Irgens LM, Lie RT. Long term mortality of mothers and fathers after pre-eclampsia: population based cohort studyPre-eclampsia and cardiovascular disease later in life: who is at risk? Bmj. 2001;323(7323):1213-7.
2-Dolea C, AbouZahr C. Global burden of hypertensive disorders of pregnancy in the year 2000. GBD 2000 Working Paper, World Health Organization, Geneva. http://www.who.int/evidence/bod . 2003b.“Global Burden of Obstructed Labor in the Year 2000.” GBD 2000 Working Paper, World Health Organization, Geneva. http://www.who. int/evidence/bod, 2003.
3-Wallis AB, Saftlas AF, Hsia J, Atrash HK. Secular trends in the rates of preeclampsia, eclampsia, and gestational hypertension, United States, 1987-2004. Am J Hypertens. 2008;21(5):521-6.
4-Duley L, editor The global impact of pre-eclampsia and eclampsia. Seminars in perinatology; 2009: Elsevier.
5-Chang J, Elam-Evans LD, Berg CJ, Herndon J, Flowers L, Seed KA, et al. Pregnancy-related mortality surveillance--United States, 1991--1999. MMWR Surveill Summ. 2003;52(2):1-8.
6-Main EK. Maternal mortality: new strategies for measurement and prevention. Current opinion in obstetrics & gynecology. 2010;22(6):511-6.
7-            Mac KAP, Berg CJ, Liu X, Duran C, Hoyert DL. Changes in pregnancy mortality ascertainment: United States, 1999-2005. Obstetrics and gynecology. 2011;118(1):104-10.
8-Livingston JC, Livingston LW, Ramsey R, Mabie BC, Sibai BM. Magnesium sulfate in women with mild preeclampsia: a randomized controlled trial. Obstetrics and gynecology. 2003;101(2):217-20.
9-MacKay AP, Berg CJ, Atrash HK. Pregnancy-related mortality from preeclampsia and eclampsia. Obstetrics and gynecology. 2001;97(4):533-8.
10-Schutte JM, Steegers EA, Schuitemaker NW, Santema JG, de Boer K, Pel M, et al. Rise in maternal mortality in the Netherlands. BJOG : an international journal of obstetrics and gynaecology. 2010;117(4):399-406.
11-Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. Bmj. 2005;330(7491):565.
12-Roberts JM, Redman CW. Pre-eclampsia: more than pregnancy-induced hypertension. The Lancet. 1993;341(8858):1447-51.
13-Meekins JW, Pijnenborg R, Hanssens M, McFadyen IR, van Asshe A. A study of placental bed spiral arteries and trophoblast invasion in normal and severe pre-eclamptic pregnancies. British journal of obstetrics and gynaecology. 1994;101(8):669-74.
14-Maynard SE, Karumanchi SA, editors. Angiogenic factors and preeclampsia. Seminars in nephrology; 2011: Elsevier.
15-Desai DK, Moodley J, Naidoo DP, Bhorat I. Cardiac abnormalities in pulmonary oedema associated with hypertensive crises in pregnancy. British journal of obstetrics and gynaecology. 1996;103(6):523-8.
16-Minakami H, Oka N, Sato T, Tamada T, Yasuda Y, Hirota N. Preeclampsia: a microvesicular fat disease of the liver? Am J Obstet Gynecol. 1988;159(5):1043-7.
17-Dani R, Mendes GS, De Laurentys Medeiros J, Péret FJ, Nunes A. Study of the liver changes occurring in preeclampsia and their possible pathogenetic connection with acute fatty liver of pregnancy. American Journal of Gastroenterology. 1996;91(2).
18-Sibai BM, Lindheimer M, Hauth J, Caritis S, VanDorsten P, Klebanoff M, et al. Risk factors for preeclampsia, abruptio placentae, and adverse neonatal outcomes among women with chronic hypertension. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. The New England journal of medicine. 1998;339(10):667-71.
19-Menzies J, Magee L, Macnab Y, Ansermino J, Li J, Douglas M, et al. Current CHS and NHBPEP criteria for severe preeclampsia do not uniformly predict adverse maternal or perinatal outcomes. Hypertension in Pregnancy. 2007;26(4):447-62.
20-Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd W, Leveno KJ, et al. Subclinical hypothyroidism and pregnancy outcomes. Obstetrics and gynecology. 2005;105(2):239-45.
21-Qublan HS, Al-Kaisi IJ, Hindawi IM, Hiasat MS, Awamleh I, Hamaideh AH, et al. Severe pre-eclampsia and maternal thyroid function. Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology. 2003;23(3):244-6.
22-Kumar A, Ghosh BK, Murthy NS. Maternal thyroid hormonal status in preeclampsia. Indian J Med Sci. 2005;59(2):57-63.
23-Raoofi Z, Jalilian A, Zanjani MS, Parvar SP, Parvar SP. Comparison of thyroid hormone levels between normal and preeclamptic pregnancies. Medical journal of the Islamic Republic of Iran. 2014;28:1.
24-Elhaj ET, Adam I, Alim A, Elhassan EM, Lutfi MF. Thyroid Function/Antibodies in Sudanese Patients with Preeclampsia. Front Endocrinol (Lausanne). 2015;6:87.
25-Williams D, editor Long-term complications of preeclampsia. Seminars in nephrology; 2011: Elsevier.
26-Wang A, Rana S, Karumanchi SA. Preeclampsia: the role of angiogenic factors in its pathogenesis. Physiology (Bethesda). 2009;24(3):147-58.
27-Troeger C, Holzgreve W, Ladewig A, Zhong XY, Hahn S. Examination of maternal plasma erythropoietin and activin A concentrations with regard to circulatory erythroblast levels in normal and preeclamptic pregnancies. Fetal Diagn Ther. 2006;21(1):156-60.
28-Wilson KL, Casey BM, McIntire DD, Halvorson LM, Cunningham FG. Subclinical thyroid disease and the incidence of hypertension in pregnancy. Obstetrics and gynecology. 2012;119(2 Pt 1):315-20.
29-Kharb S, Sardana D, Nanda S. Correlation of thyroid functions with severity and outcome of pregnancy. Ann Med Health Sci Res. 2013;3(1):43-6.
30-Kumar A, Khatuja R, Mehta S. Thyroid dysfunction during pregnancy and in postpartum period: treatment and latest recommendations. Archives of gynecology and obstetrics. 2014;289(5):1137-44.
31-Zhou J, Du J, Ma B, Liu X, Qiu H, Li J, et al. [Thyroid hormone changes in women with pre-eclampsia and its relationship with the presence of pre-eclampsia]. Zhonghua Fu Chan Ke Za Zhi. 2014;49(2):109-13.
32-          Negro R, Formoso G, Mangieri T, Pezzarossa A, Dazzi D, Hassan H. Levothyroxine treatment in euthyroid pregnant women with autoimmune thyroid disease: effects on obstetrical complications. The Journal of clinical endocrinology and metabolism. 2006;91(7):2587-91.