Research Paper
Influence of maternal diabetes mellitus and maternal anemia on cord blood TSH
Author: : Kulshrestha R1, Bhadra J2, Kulshrestha MR3, Bansal P4, Dokwal S5, Dhupper V2
*1Senior resident, Department of obstetrics and gynecology,
Modern Institute of Medical Sciences,
Indore, Madhya Pradesh, India.
*2PG resident, Department of biochemistry,
Pt BDSPGIMS,
Rohtak, India.
*3Assistant Professor, Department of biochemistry,
Modern Institute of Medical Sciences,
Indore, Madhya Pradesh, India
*4Assistant Professor, Department of biochemistry,
BPS Govt. Medical College for Women, Khanpur Kalan,
Khanpur, India.
*5Assistant Professor, Department of biochemistry,
Pt BDSPGI
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Abstract
Introduction
:
The cord blood TSH
(CBTSH) levels may be elevated because of antenatal
complications. This can lead to false positives in screening of congenital
hypothyroidism. Thus, this study is aimed to evaluate the effect of maternal anemia
and maternal diabetes mellitus on cord blood TSH.
Materials
and methods
:
This cross
sectional study included 734 term newborns. Neonates
who were born preterm (<37week) or weighed <2.5Kg, those with
major life threatening malformation or antenatally detected central nervous
system malformations and those whose mothers were on any antithyroid drugs or
had pre eclampsia were excluded from the study. Information about mother’s
health status was noted from hospital records. Depending upon the profiles of
the newborns and their mothers, 4 groups were formed. Group 1 served as the
control (n=306), group 2 (n=74), group 3 (n=333) and group 4 (n=21) had
newborns whose mothers had diabetes
mellitus only, anemia only and diabetes mellitus and anaemia both respectively.
Cord blood samples were analyzed for TSH using sandwich immunoassay on Elecys
2020.
Results
:
The median CBTSH
(IQR) value for group 1, 2, 3 and 4 were 6.72 mIU/ml (3.6), 7.0 mIU/ml (4.9),
7.9 mIU/ml (6.0) and 8.7 mIU/ml (5.5) respectively. CBTSH levels was significantly
raised in newborns of diabetic mothers (p =0.030), anaemic mothers (p=0.001)
and mothers with both diabetes & anaemia (p=0.004) in comparison to those
born to mothers without these diseases (controls; group1).
Conclusion
:
Our results show
that cord blood TSH is significantly affected in presence of maternal anemia
and gestational diabetes mellitus. This may be due to placental insufficiency
and fetal hypoxia associated with these conditions, which results in
intrauterine fetal stress.
Keywords
: Cord blood TSH,
Congenital hypothyroidism screening, maternal anemia, gestational diabetes
mellitus
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