The relationship between complete blood count parameters with thyroid stimulating hormone levels in pregnant women

Document Type : Original Article

Authors

1 M.Sc. student of Midwifery Education, Student Research Committee, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran.

2 PhD student in Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

3 B.Sc student of nutrition, Student Research Committee, Faculty of Medicine, Zahdan University of Medical Sciences, Zahdan, Iran.

Abstract

Introduction: Iron deficiency anemia reduces the activity of thyroperoxidase and thus inhibits the production of thyroid hormone. Therefore, this study was performed with aim to determine the relationship between complete blood count parameters with the level of thyroid stimulating hormone in pregnant women.
Methods: This descriptive-analytical cross-sectional study was performed in 2018 on 130 pregnant women who had referred to community health centers covered by Gonabad University of Medical Sciences for first prenatal care. Data were collected at maternal referral, using a checklist containing demographic information of maternity (maternal age, education, occupation, gestational age, etc.) and first trimester pregnancy test results. Data were analyzed by SPSS software (version 16) and Kolmogorov-Smirnov, Spearman correlation and Pearson correlation tests. P<0.05 was considered statistically significant.
Results: Mean TSH of women was 1.95± 1.24 mlu/l and mean total Hb was 12.81±1.08 g/dl and mean total MCHC was 23.89±1.34 g/dl. In multivariate model, none of the variables had a significant statistical relationship with TSH and only the MCHC variable had a significant relationship with TSH (P = 0.041).
Conclusion: The MCHC variable had a significant relationship with TSH, but the other blood parameters had no significant relationship with TSH level. It is recommended that further studies be performed in the future to determine the relationship between these two variables.

Keywords


  1. Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, et al. Williams Obstetrics. 25nd New York: McGraw-Hill Education; 2018.
  2. Glinoer D. The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocrine reviews 1997; 18(3):404-33.
  3. Braverman LE, Cooper D. Werner & Ingbar's the thyroid: a fundamental and clinical text. Lippincott Williams & Wilkins; 2012.
  4. Cooper DS. Thyroid hormone and pregnancy. JAMA 2000; 259(1):31-75.
  5. Cignini P, Cafà EV, Giorlandino C, Capriglione S, Spata A, Dugo N. Thyroid physiology and common diseases in pregnancy: review of literature. Journal of prenatal medicine 2012; 6(4):64.
  6. Biglievi EG, Salton PE. Pregnancy and primay hypothyroidism. J Clin Endocrinol Metab 2003; 27(1):1628-30.
  7. Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, et al. 2017 Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid 2017; 27(3):315-89.
  8. Stagnaro-Green A, Abalovich M, Alexander E, Azizi F, Mestman J, Negro R, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 2011; 21(10):1081-125.
  9. Azizi F, Delshad H. Thyroid derangements in pregnancy. Iranian Journal of Endocrinology and Metabolism 2014; 15(6):491-508.
  10. Surks MI, Ortiz E, Daniels GH, Sawin CT, Col NF, Cobin RH, et al. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. Jama 2004; 291(2):228-38.
  11. Lotfalizadeh M, Ghomian N, Mohammad Nezhad M. Prevalence and complications of hypothyroidism in pregnancy. Iran J Obstet Gynecol Infertil 2017; 20(8):1-5.
  12. Sahu MT, Das V, Mittal S, Agarwal A, Sahu M. Overt and subclinical thyroid dysfunction among Indian pregnant women and its effect on maternal and fetal outcome. Archives of gynecology and obstetrics 2010; 281(2):215-20.
  13. Casey BM, Dashe JS, Wells CE, McIntire DD, Leveno KJ, Cunningham FG. Subclinical hyperthyroidism and pregnancy outcomes. Obstetrics & Gynecology 2006; 107(2):337-41.
  14. Abalovich M, Alcaraz G, Kleiman-Rubinsztein J, Pavlove MM, Cornelio C, Levalle O, et al. The relationship of preconception thyrotropin levels to requirements for increasing the levothyroxine dose during pregnancy in women with primary hypothyroidism. Thyroid 2010; 20(10):1175-8.
  15. Alexander EK, Marqusee E, Lawrence J, Jarolim P, Fischer GA, Larsen PR. Timing and magnitude of increases in levothyroxine requirements during pregnancy in women with hypothyroidism. New England Journal of Medicine 2004; 351(3):241-9.
  16. Rezvani MR, Malek F, Ghotaslou A, Kamali M. Investigation of relation between Iron deficiency anemia and hypothyroidism. Razi Journal of Medical Sciences 2016; 23(149):89-97.
  17. Ravanbod M, Asadipooya K, Kalantarhormozi M, Nabipour I, Omrani GR. Treatment of iron-deficiency anemia in patients with subclinical hypothyroidism. The American journal of medicine 2013; 126(5):420-4.
  18. Azizi F, Mirmiran P, Sheikholeslam R, Hedayati M, Rastmanesh R. The relation between serum ferritin and goiter, urinary iodine and thyroid hormone concentration. International journal for vitamin and nutrition research 2002; 72(5):296-9.
  19. Akhter S, Naher ZU, Pervin S, Nahar K, Ali M, Bashar T, et al. The status of thyroid hormones in iron deficient patients in Bangladesh. Medicine today 2012; 24(1):1-4.
  20. Rostaei Rad N, Vakili M, Zavar-reza J, Rezaie S, Shirvani AR. The relationship between thyroid hormone levels and body iron status in iranian hypothyroidism patients. International Journal of Medical Laboratory 2016; 3(3):176-84.
  21. Dorgalaleh A, Mahmoodi M, Varmaghani B. Effect of thyroid dysfunctions on blood cell count and red blood cell indice. Iranian journal of pediatric hematology and oncology 2013; 3(2):73.
  22. Shiravand Z, Talaei A. Effect of Iron on Thyroid Function in Women with Hypothyroidism: A Double-blind Clinical Trial Study. Journal of Arak University of Medical Sciences 2019; 22(4):124-33.