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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (1): 111-116    DOI: 10.31083/j.ceog.2020.01.4975
Original Research Previous articles | Next articles
Relationship between subclinical hypothyroidism during pregnancy and hypertensive disorder complicating pregnancy and its poor prognosis
W.X. Chen1, L.Y. Tang1, *()
1Department of obstetrics, Shanghai Changning Maternal & Infant Health Hospital, Shanghai, China
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Objectives: Pregnancy-induced hypertension syndrome (PIH) is a common disease of pregnant women. This study explored the correlation between subclinical hypothyroidism (SCH) and PIH and the prognosis of patients with PIH. Materials and Methods: The study included 180 pregnant women were divided into three groups, including PIH+SCH group, PIH+non-SCH group, and normal group. Immunofluorescence method was used to detect thyroid stimulating hormone (TSH). Student’s t-test and chi-square test were used to analyze the difference between two groups. Pearson correlation analysis was used to assess the correlation between two variables. Results: Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were all significantly upregulated in PIH+SCH group compared with those in normal group and PIH+ non-SCH groups (all p < 0.05) and SCH had a close relationship with SBP (r 2= 0.2163, p = 0.0002). The incidences of postpartum hemorrhage, premature delivery, abortion, FGR, and pregnancy anemia were all cleary increased in PIH+non-SCH, and PIH+SCH groups, compared with those in normal group, respectively (8.3, 10, 13.3, 1 8.3, 23.3; 13.3, 23.3, 26.7, 35, and 36.7 vs.1.7, 5, 3.3, 1.7, and 5.1 (all p < 0.05). The incidences of premature delivery, abortion, FGR, and pregnancy anemia were significantly higher in PIH+SCH group than PIH+non-SCH group (23.3, 26.7, 35, and 36.7 vs. 10, 13.3, 18.3, 23.3 (all p < 0.05). Moreover, serum TSH level was significantly increased in high gestational week group compared with low gestational week group (6.86 ± 0.78 vs. 5.79 ± 0.45, p < 0.05) and SBP, DBP, and MAP were all remarkably elevated in high gestational week group compared with low gestational week group (167.6 ± 12.4 vs. 150.9 ± 10.8; 108.5 ± 11.4 vs. 95.2 ± 11.2; 121.8 ± 13.6 vs. 110.0 ± 12.3 (all p < 0.05). In addition, compared with those in low TSH group, the incidences of postpartum hemorrhage, premature delivery, abortion, FGR, and pregnancy anemia were all obviously increased in high TSH group (all p < 0.05). Conclusion: SCH had a close association with PIH and poor prognosis during pregnancy.

Key words:  Subclinical hypothyroidism      Pregnancy-induced hypertension syndrome      Thyroid stimulating hormone      Systolic blood pressure.     
Published:  15 February 2020     
*Corresponding Author(s):  L.Y. Tang     E-mail:

Cite this article: 

W.X. Chen, L.Y. Tang. Relationship between subclinical hypothyroidism during pregnancy and hypertensive disorder complicating pregnancy and its poor prognosis. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(1): 111-116.

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Figure 1.  — Relationship between SCH during pregnancy and PIH. (A) the serum level of TSH in three groups. (B) Relationship between SCH and SBP. (C) Relationship between SCH and DBP. (D) Relationship between SCH and MAP

Table 1  — The baseline information of the three groups.
Characteristics PIH+ SCH
(n = 60)
PIH+ non-SCH
(n= 60)
Normal group
(n = 60)
P value
Age (year) 27.9±5.9 27.5±6.2 28.2±6.7 >0.05
Han 58 55 57 >0.05
Minority 2 5 3
Registered residence
Urban 30 32 27 >0.05
Rural 30 28 33
Gestational week 28.5±6.9 28.9±7.1 26.3±6.4 >0.05
BMI (kg/m2) 27.2±5.4 28.2±4.3 28.4±6.4 >0.05
Table 2  — Arterial blood pressure in three groups.
SBP(mmHg) DBP(mmHg) MAP(mmHg)
Normal group 113.3+10.4 86.4+7.9 90.4+8.2
PIH+ non-SCH 147.2+5.6a 95+3.7a 105.7+4.1a
PIH+ SCH group 158.4+6.5ab 101.2+3.4ab 115.3+3.9ab
Table 3  — Comparison of pregnancy outcome between three groups.
Normal group (n=60) PIH+non-SCH (n=60) PIH+SCH group (n=60)
Postpartum hemorrhage 1 (1.7) 5 (8.3)a 8 (13.3)a
Premature delivery 3 (5) 6 (10)a 14 (23.3)ab
Abortion 2 (3.3) 8 (13.3)a 16 (26.7)ab
FGR 1 (1.7) 11 (18.3)a 21 (35)ab
Placental abruption 1 (1.7) 3 (5.1) 4 (6.8)
Pregnancy anemia 3 (5.1) 14 (23.3)a 22 (36.7)ab
Table 4  — Comparison of pregnancy outcome in different TSH level.
Low TSH group (n=32) High TSH group (n=28)
Postpartum hemorrhage 2 (6.3) 6 (21.4)a
Premature delivery 3 (9.4) 11 (39.3)a
Abortion 4 (12.5) 12 (42.9)a
FGR 5 (15.6) 16 (57.1)a
Placental abruption 2 (6.3) 2 (7.1)
Pregnancy anemia 6 (18.8) 16 (57.1)a
Figure 2.  — TSH level and arterial blood pressure in different gestational weeks. (A) the serum level of TSH in two groups. (B) SBP in two groups. (C) DBP in two groups. (D) MAP in two groups.

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