Abstract

Background: Thyroid disorders are the most common endocrine abnormalities faced during pregnancy and are associated with adverse maternal and neonatal outcomes. In Bangladesh, delayed antenatal booking, variable access to laboratory testing, and lack of uniform thyroid screening contributes to missed or late diagnosis. Objective: To evaluate the clinical profile of pregnant women with thyroid disorders and determine their association with maternal and perinatal outcomes. Methods: This cross-sectional observational study was conducted at the Department of Obstetrics and Gynaecology, Khawja Yunus Ali Medical College Hospital, Enayetpur, Sirajganj, Bangladesh, from January 2023 to December 2025. A total of 252 pregnant women with thyroid dysfunction and 252 euthyroid controls were enrolled. Thyroid dysfunction was classified according to the American Thyroid Association (ATA) defined thyroid function criteria in pregnancy using trimester-specific reference ranges. Maternal demographic characteristics, thyroid profiles, treatment characteristics, obstetric complications, and neonatal outcomes were recorded. Results: Subclinical hypothyroidism was the predominant thyroid disorder (57.9%), followed by overt hypothyroidism (32.1%). Compared with euthyroid controls, women with thyroid dysfunction had significantly higher rates of pregnancy-induced hypertension (12.7% vs 6.0%), preterm birth (28.6% vs 13.9%), low birth weight (21.8% vs 10.7%), fetal growth restriction (IUGR) (11.9% vs 5.2%), and cesarean delivery (59.1% vs 44.5%). Adjusted logistic regression showed that thyroid dysfunction was independently associated with preterm birth, low birth weight, NICU admission, pregnancy-induced hypertension, fetal growth restriction, and cesarean section. Conclusion: Thyroid dysfunction during pregnancy was independently associated with adverse maternal and neonatal outcomes.

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