Effects of hypothyroidism on pregnant women and fetuses

The article was professionally consulted by Specialist Doctor II Pham Thi Tuyet Mai - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Hai Phong International General Hospital.

Hypothyroidism during pregnancy can cause serious complications, affecting both the mother and the fetus. Therefore, mothers need to know the early signs of hypothyroidism in order to timely intervene as well as prevent the disease by newborn screening measures.

The thyroid gland is an important endocrine gland that regulates the body's metabolism. During pregnancy, the thyroid gland increases its intake of iodine to ensure normal levels of thyroid hormone production. So in areas where there is not enough iodine in the daily diet, the thyroid gland can enlarge during pregnancy. About 1% of pregnant women have hypothyroidism.
Hypothyroidism during pregnancy is a condition in which a decrease in the level of thyroid hormone in the blood will cause hypothyroidism, in which case the function of the thyroid gland will be disturbed, not releasing enough thyroid hormone.

Causes of hypothyroidism during pregnancy include:
The most common cause is chronic autoimmune thyroiditis, also known as Hashimoto's disease. The disease may be present before pregnancy or may appear for the first time during pregnancy. Other causes of hypothyroidism may be due to thyroidectomy or radioactive iodine treatment, or from being treated with Graves with too high a dose of synthetic antithyroid drugs. Cases with a family history of many thyroid diseases, people with large goiters, people with thyroiditis or hypothyroidism in a previous pregnancy, pregnant women in the area with iodine deficiency need to be monitored and investigated. .

2.1 Effects of hypothyroidism on pregnant women If hypothyroidism is left untreated or inadequately treated, the mother can suffer all the complications of hypothyroidism such as sluggishness, constipation, anemia. , muscle weakness, heart failure,... Risk of complications related to obstetrics including: low birth weight, preeclampsia, postpartum bleeding,... even miscarriage. These complications are most common in women with severe hypothyroidism, while mild cases of hypothyroidism may have no symptoms. 2.2 Effects of hypothyroidism on the fetus The fetal thyroid gland is only formed and begins to function at 10-12 weeks of pregnancy. During the first 12 weeks, the fetus is completely dependent on the mother's source of thyroid hormone. If the mother has hypothyroidism, the baby will also have hypothyroidism. In addition, the fetus depends on the amount of iodine provided by the mother. Thyroid hormone plays an extremely important role in the division, formation of organs as well as brain development of children. If left untreated, it can lead to miscarriage, stillbirth and birth defects, including cretinism. Children with congenital hypothyroidism can have severe abnormalities in both intellectual and physical development if not detected and treated promptly.

The cause of hypothyroidism in pregnancy is unknown. However, during pregnancy, the body increases its tolerance to iodine to ensure normal levels of thyroid hormone production. In our country, especially in mountainous areas, the food often lacks iodine, so most people here often suffer from goiter. Therefore, the best prevention is to implement well the goiter prevention program of the Ministry of Health, which is to use iodized salt instead of normal salt in daily meals.
Some preventive measures include:
Pregnant people need to choose iodine-rich foods such as sea fish, eggs, milk, dark green vegetables, yellow ripe fruits... Cooking soup needs to Once cool, add salt to the soup to avoid evaporation, because iodine is very volatile when exposed to high temperatures. From adolescence, if a goiter is detected, it must be treated early even if it is a simple goiter. Screening is recommended for mothers in the first 3 months of pregnancy and, preferably, for women who want to become pregnant. Especially in women at risk. Women with thyroid disease if they want to get pregnant, it is best to stabilize the disease until it is completely cured. While being treated for the disease, if you have an unwanted pregnancy but want to keep the pregnancy, you should immediately go to a medical facility for an endocrinology examination to be consulted and give the best advice. Newborn screening right after birth to detect cases of congenital hypothyroidism early so that the child can be treated early, avoiding long-term consequences. In short, hypothyroidism during pregnancy has a significant impact on the mother and fetus, and can even lead to miscarriage. Therefore, to prevent hypothyroidism, it is best for mothers to be screened in the first 3 months of pregnancy.
During pregnancy, it is necessary to supplement fully with nutrients and iodine for pregnant women, especially foods such as sea fish, eggs, yellow ripe fruit... When there are any signs of any abnormalities Usually, it is necessary to go to a medical facility immediately for examination and timely interventions to avoid unwanted consequences.
At Vinmec International General Hospital, pregnant women will be examined and consulted carefully to detect early warning signs of hypothyroidism affecting the fetus. During labor, pregnant women will be monitored and cared for according to standard procedures and protocols, especially relatives will be allowed to enter the delivery room to accompany the mother. In addition, the clinic and delivery room are always fully equipped with fetal heart monitors and have an oxygen system available to immediately supply to the mother when needed.