Endocrine Abstracts

Background and aims

Gestational diabetes mellitus (GDM) is a disease manifested by hyperglycemia, first diagnosed during pregnancy, which usually resolves after delivery. In GDM, there is a risk of adverse effects in both a mother and a fetus. Thyroid hormones (TG) play a huge role in the proper development of the child. Given the high prevalence of thyroid pathology and disorders of carbohydrate metabolism during pregnancy, the study of the relationship between these diseases and the prevalence of hypothyroidism in this group of pregnant women is relevant to improve the effectiveness of treatment and prevent complications.

Materials and methods

Retrospective analysis of individual pregnancy cards for 2019 based on the antenatal clinics of the Moscow Department of Health V.P. Demikhov Hospital. All women underwent a study of fasting blood plasma glucose, TSH, free T3, free T4, antibodies to thyroid peroxidase (TPO), an oral glucose tolerance test was performed at 24–28 weeks of gestation.

Results

Outpatient records of 779 pregnant women aged 19 to 46 years were evaluated, of which 599 patients were diagnosed with GDM. The average age of pregnant women with GDM was 33 years. Diet therapy was prescribed in 100% of cases. 349 (58.26%) pregnant women with GDM had no concomitant pathology. In 114 (19.03%) cases of GDM manifest hypothyroidism was revealed; in 19 (3.17%) cases, there was subclinical hypothyroidism as a result of autoimmune thyroiditis (AIT); 46 patients showed carriage of antibodies to TPO with a normal TSH level. The average values of hormonal parameters in the study group were: FT3 – 3.44 (0.36–15.8) pmol/l, FT4 – 2.33 (0.099–19.4) pmol/l, TSH – 3.15 (0.02–8.72) mIU/l. 74% of pregnant women with GDM had a BMI of 25 to 30 kg/m², with a mean of 27.3 kg/m². In 92 (15.35%) pregnant women, GDM developed against the background of obesity (BMI over 30 kg/m²); 19 (3.17%) patients with GDM had hypothyroidism and obesity.

Conclusions

According to the conducted statistical analysis, it follows that GDM occurs more often in women with overweight at the time of gestation. GDM in this group of pregnant women is often combined with hypothyroidism and the carriage of antibodies to TPO. In this connection, further study of the relationship between these pathologies is required.