Prevalences of subclinical and overt hypothyroidism with universal screening in early pregnancy.

PURPOSE: To reveal the prevalence of subclinical and overt hypothyroidism among Turkish population during pregnancy. Also to investigate the prevalence of hypothyroidism using ATA 2017 criteria. METHODS: This is a cross-sectional study. Patients were consisted of 1416 consecutive pregnant women who were universally screened for thyroid disease in their first trimester between 2013 and 2015. Thyroid-stimulating hormone (TSH) and free T4 (FT4) levels were analyzed during the first antenatal visit (before 12 weeks of gestation). We compared different cutoffs for TSH. We further determined the 2.5th and 97.5th percentiles for TSH and FT4. RESULTS: Initially, the cutoff of 2.5 IU/ml was selected. Accordingly, 305 women (22.3%) had subclinical hypothyroidism and 22 (1.6%) was diagnosed with overt hypothyroidism. When the cutoff was increased to 4 IU/ml, only 40 (2.9%) women were diagnosed with hypothyroidism. Prevalences of overt hypothyroidism and subclinical hypothyroidism were 0.6% and 2.3%, respectively. CONCLUSION: Universal screening of pregnant women with TSH, using the 2.5 mIU/L cutoff; one in four women was found to be a candidate for thyroid hormone replacement in our cohort. When the cutoff was determined to be 4 mIU/L, prevalence of hypothyroidism decreased approximately 10 times.

Prevalence of gestational diabetes mellitus evaluated by universal screening with a 75-g, 2-hour oral glucose tolerance test and IADPSG criteria.

OBJECTIVE: To determine the prevalence of gestational diabetes mellitus (GDM) and its association with maternal age among Turkish women diagnosed by International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. METHODS: A cross-sectional study was conducted in 2013-2015 among non-diabetic pregnant women aged 18-49 years who were universally screened for GDM by IADPSG criteria. The percentage of women meeting each diagnostic threshold and the prevalence of GDM by age group were calculated. Linear trends were evaluated by logistic regression. RESULTS: Among 1434 women screened, 159 (11.1%, 95% confidence interval 9.5%-12.7%) were diagnosed with GDM; eleven of these women had been diagnosed according to a fasting glucose level in the first trimester. The prevalence of GDM was 6.6% (10/151), 7.3% (37/507), 8.8% (42/479), 16.7% (45/270), and 35.2% (25/71) among women aged younger than 25, 25-29, 30-34, 35-39, and 40 years or older, respectively. GDM prevalence increased with age (P<0.001). The numbers of women diagnosed with GDM in the second trimester who exceeded one, two, and three thresholds of the 2-hour oral glucose tolerance test were 66 (44.6%), 52 (35.1%), and 30 (20.3%), respectively. CONCLUSION: Prevalence of GDM was correlated with maternal age. Most women diagnosed in the second trimester exceeded the threshold at only one of the three timepoints.