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June 21, 2026Open Access

Hypothyroidism in Pregnancy: A Systematic Review of Maternal and Fetal Outcomes

TSTongbram Bidyananda SinghIndira Gandhi Institute of Medical Sciences PRPrasant RoyIndira Gandhi Medical College KKKeleriano Keleriano

Puntos clave

The review aims to synthesize evidence on how overt and subclinical hypothyroidism during pregnancy affect maternal and fetal outcomes.
Conducted a systematic search of studies from 2015 to 2025 across various scientific databases.
Included original research on maternal and neonatal outcomes for women with hypothyroidism.
Extracted and synthesized relevant data to identify trends and findings.
Overt hypothyroidism is linked to increased risks of miscarriage, hypertension, anemia, and low birth weight.
Neonates from affected mothers often require neonatal intensive care support.
Subclinical hypothyroidism is associated with pregnancy loss and fetal growth issues, especially if untreated.

Resumen

Background: Hypothyroidism is among the most prevalent endocrine disorders encountered during pregnancy, presenting either as overt hypothyroidism (OH) or subclinical hypothyroidism (SCH). Maternal thyroid hormones are essential for maintaining normal pregnancy physiology and supporting fetal growth and neurodevelopment. Accumulating evidence suggests that thyroid dysfunction during pregnancy substantially contributes to adverse maternal and neonatal outcomes. Objective: This systematic review aims to synthesize recent evidence on the association between overt and subclinical hypothyroidism during pregnancy and their effects on maternal and fetal outcomes. Methods: A systematic search of studies published between 2015 and 2025 was conducted using PubMed, Scopus, Web of Science, and Google Scholar. Original research articles evaluating maternal and neonatal outcomes in pregnant women diagnosed with overt or subclinical hypothyroidism were included. Relevant data were extracted, reviewed, and synthesized to identify common findings and trends. Results: Reviewed studies consistently demonstrated that overt hypothyroidism is associated with increased risks of miscarriage, gestational hypertension, preeclampsia, anemia, placental abnormalities, preterm birth, and low birth weight. Neonates of affected mothers were more likely to require neonatal intensive care. Subclinical hypothyroidism, though generally less severe, was significantly associated with pregnancy loss, preterm delivery, fetal growth restriction, and neonatal complications, particularly when left untreated. Early diagnosis and appropriate levothyroxine therapy improved pregnancy outcomes. Conclusion: Both overt and subclinical hypothyroidism are important contributors to adverse maternal and fetal outcomes. Early screening, timely laboratory diagnosis, and effective management are essential. Further high-quality evidence is needed to establish standardized global screening and treatment strategies.

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