title: Prevalence of hypothyroidism in pregnancy: An epidemiological study from 11 cities in 9 states of India.
abstract: BACKGROUND
  A previous hospital based study from Delhi revealed a high prevalence of hypothyroidism in pregnant women. Several other studies with small sample size also indicate a rising trend of prevalence of hypothyroidism during pregnancy in India.
  
  
  OBJECTIVE
  To assess prevalence of hypothyroidism in pregnant women from various states/cities across India.
  
  
  METHODS
  This was a cross-sectional multicenter study conducted at Allahabad (Uttar Pradesh), Bengaluru (Karnataka), Chennai (Tamil Nadu), Kolkata (West Bengal), Hyderabad (Telangana), Nasik (Maharashtra), Rohtak (Haryana), Pune (Maharashtra), New Delhi (Delhi), Srinagar (Kashmir), and Vizag (Andhra Pradesh) enrolling 2599 pregnant women. Estimation of thyroid stimulating hormone (TSH), free T4, and antithyroid peroxidase (TPO) antibodies was carried out using Roche modular kit using ECLIA technology in a central laboratory.
  
  
  RESULTS
  We found in our study population that 13.13% of pregnant women have hypothyroidism (n = 388), using a cutoff TSH level of 4.5 μIU/ml. This prevalence was much higher using the American Thyroid Association criteria. Anti-TPO antibodies were positive in 20.74% of all pregnant women (n = 613), whereas 40% (n = 155) of hypothyroid pregnant women were positive for anti-TPO antibodies.
  
  
  CONCLUSIONS
  This study concludes that there is a high prevalence of hypothyroidism (13.13%), majority being subclinical in pregnant women during the first trimester from India and universal screening of hypothyroidism may be desirable in our country.
authors.affiliation: Department of Endocrinology, Consultant Endocrinologist, NMC Specialty Hospital, Abu Dhabi, UAE.
authors.forename: Dinesh Kumar
authors.initials: DK
authors.lastname: Dhanwal
authors.affiliation: Department of Medicine, MLN Medical College, Allahabad, Uttar Pradesh, India.
authors.forename: Sarita
authors.initials: S
authors.lastname: Bajaj
authors.affiliation: Department of Endocrinology and Medicine, Pt. B.D.Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Rajput
authors.affiliation: Department of Medicine and Endocrinology, King Georges Hospital, Visakhapatnam, Andhra Pradesh, India.
authors.forename: K A V
authors.initials: KA
authors.lastname: Subramaniam
authors.affiliation: Department of Endocrinology, IPGME and R and SSKM Hospital, Kolkata, West Bengal, India.
authors.forename: Subhankar
authors.initials: S
authors.lastname: Chowdhury
authors.affiliation: Shree Balaji Hospital, Nashik, Maharashtra, India.
authors.forename: Rajendra
authors.initials: R
authors.lastname: Bhandari
authors.affiliation: Bangalore Endocrinology and Diabetes Research Centre, MS Ramaiah Medical College and Hospital, Bengaluru, Karnataka, India.
authors.forename: Mala
authors.initials: M
authors.lastname: Dharmalingam
authors.affiliation: Department of Endocrinology, Osmania Medical College, Hyderabad, Telangana, India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Sahay
authors.affiliation: Department of Endocrinology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Ganie
authors.affiliation: Command Hospital, New Delhi, India.
authors.forename: Narendra
authors.initials: N
authors.lastname: Kotwal
authors.affiliation: ACEER, Chennai, Tamil Nadu, India.
authors.forename: Usha
authors.initials: U
authors.lastname: Shriram
keywords: Epidemiology; hypothyroidism; pregnancy