Work

Clinical Predictors of Postpartum Persistent Hypothyroidism in Gestational Hypothyroidism: A Cohort Study

Year: 2026

Type: article

Abstract: OBJECTIVE: The aims of this study were to determine whether gestational timing, biochemical severity, treatment response, or metabolic parameters predict postpartum persistent hypothyroidism and to evaluate the contribution of thyroid autoimmunity. MATERIAL AND METHODS: This single-center retrospective cohort study included pregnant women newly diagnosed with hypothyroidism in an internal medicine outpatient clinic. Recorded variables included demographic characteristics, gestational age at diagnosis, baseline thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels, follow-up thyroid function tests, fasting glucose, oral glucose tolerance test results, gestational diabetes diagnosis, and thyroid function at 6 weeks postpartum. Patients were categorized into early (≤13 weeks), mid (14-27 weeks), and late (≥28 weeks) diagnosis groups. Associations between gestational timing, treatment response, glycemic parameters, and postpartum persistent hypothyroidism were analyzed. RESULTS: Fifty-eight women were included. Trimester-specific TSH targets were achieved in 32/58 (55.2%) at the first follow-up and 42/58 (72.4%) at the second follow-up. Early diagnosis, baseline TSH, levothyroxine dose, gestational timing, and glycemic indices were not associated with TSH normalization or postpartum persistent hypothyroidism (all p > 0.05). Postpartum persistent hypothyroidism developed in 14/58 women (24.1%). Thyroid autoantibody positivity was associated with persistence (p = 0.006) and remained independently associated with postpartum persistent hypothyroidism in multivariable analysis (odds ratio 9.78, 95% confidence interval 2.10-44.30; p = 0.020). TSH target achievement was not associated with reduced hyperglycemia. CONCLUSIONS: Thyroid autoimmunity emerged as the principal determinant of postpartum persistent hypothyroidism, supporting antibody-based risk stratification. Gestational timing, treatment response, and metabolic indices were not significantly associated with postpartum thyroid outcomes.

Source: Medical Principles and Practice

DOI: 10.1159/mpp/adpag024

Authors: Büşra Çetintulum Aydın, Seher İrem Şahin, Ece Çiftçi Öztürk, Hüseyin Öztürk, Hayriye Esra Ataoğlu

Institutions: Haseki Eğitim ve Araştırma Hastanesi, İstanbul Başakşehir Çam ve Sakura Şehir Hastanesi

Language: English

Topic: Thyroid Disorders and Treatments

Subfield: Endocrinology, Diabetes and Metabolism

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7213400302