Maternal and Neonatal Outcomes Among Pregnant Women With Hypothyroidism

Introduction: Hypothyroidism is an important endocrine disorder during pregnancy.The present study aimed to assess the prevalence of hypothyroidism and assess fetomaternal outcomes among pregnant women.Materials and methods: A prospective observational study was conducted among 300 antenatal women at Adichunchanagiri Hospital and Research Centre, Karnataka, India, from July 2024 to December 2025.Participants underwent clinical assessment and laboratory evaluation of thyroid-stimulating hormone, free thyroxine, and triiodothyronine.Thyroid dysfunction was classified using trimester-specific reference ranges.Maternal and neonatal outcomes were assessed prospectively until delivery and discharge.Data were analyzed using IBM SPSS Statistics for Windows, Version 26 (Released 2016; IBM Corp., Armonk, New York, United States).Results: Among 300 participants, 208 (69.33%) were euthyroid, 65 (21.67%) had subclinical hypothyroidism, and 27 (9.00%)had overt hypothyroidism.Preterm delivery occurred in 22 (81.48%)women with overt hypothyroidism compared with 0 (0.00%) in the euthyroid and subclinical groups (p < 0.0001).Lowersegment cesarean section (LSCS) was performed in 34 (16.35%),27 (41.54%),and 12 (44.44%)women, respectively (p < 0.0001).Low birth weight occurred in 42 (20.19%),28 (43.08%), and 27 (100.00%)neonates, while neonatal intensive care unit (NICU) admission occurred in four (1.92%), 22 (33.85%), and nine (33.33%), respectively (p < 0.0001).Mean neonatal thyroid-stimulating hormone (TSH) increased from 8.51 ± 3.40 mIU/L in the euthyroid group to 10.97 ± 3.59 mIU/L in the overt hypothyroidism group (p < 0.001).Conclusion: Maternal thyroid dysfunction, particularly overt hypothyroidism, was associated with adverse fetomaternal and neonatal outcomes.Early identification of thyroid dysfunction, appropriate management, and regular antenatal and neonatal monitoring are important for optimizing maternal and neonatal outcomes.