{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:33:42Z","timestamp":1793370822519,"version":"4.5.0"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T00:00:00Z","timestamp":1694563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014825","name":"Biotechnology Industry Research Assistance Council","doi-asserted-by":"publisher","award":["BIRAC\/GCI\/0085\/03\/14-ACT"],"award-info":[{"award-number":["BIRAC\/GCI\/0085\/03\/14-ACT"]}],"id":[{"id":"10.13039\/501100014825","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["#0PP1191052"],"award-info":[{"award-number":["#0PP1191052"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"Hypothyroidism is the commonest endocrine disorder of pregnancy, with known adverse feto-maternal outcomes. There is limited data on population-based prevalence, risk factors and outcomes associated with treatment of hypothyroidism in early pregnancy. We conducted analysis on data from an urban and peri-urban low to mid socioeconomic population-based cohort of pregnant women in North Delhi, India to ascertain the burden, risk factors and impact of treatment, on adverse pregnancy outcomes- low birth weight, prematurity, small for gestational age and stillbirth. This is an observational study embedded within the intervention group of the Women and Infants Integrated Interventions for Growth Study, an individually randomized factorial design trial. Thyroid stimulating hormone was tested in 2317 women in early (9\u201313 weeks) pregnancy, and thyroxin replacement started hypothyroid (TSH \u22652.5mIU\/mL). Univariable and multivariable generalized linear model with binomial family and log link were performed to ascertain risk factors associated with hypothyroidism and association between hypothyroidism and adverse pregnancy outcomes. Of 2317 women, 29.2% (95% CI: 27.4 to 31.1) had hypothyroidism and were started on thyroxin replacement with close monitoring. Overweight or obesity was associated with increased risk (adjusted RR 1.29, 95% CI 1.10 to 1.51), while higher hemoglobin concentration was associated with decreased risk (adjusted RR 0.93, 95% CI 0.88 to 0.98 for each g\/dL) for hypothyroidism. Hypothyroid women received appropriate treatment with no increase in adverse pregnancy outcomes. Almost a third of women from low to mid socio-economic population had hypothyroidism in early pregnancy, more so if anemic and overweight or obese. With early screening and adequate replacement, adverse pregnancy outcomes may be avoided. These findings highlight the need in early pregnancy for universal TSH screening and adequate treatment of hypothyroidism; as well as for attempts to reduce pre and peri-conception overweight, obesity and anemia.<\/jats:p>\nClinical trial registration:<\/jats:bold> Clinical trial registration of Women and Infants Integrated Interventions for Growth Study Clinical Trial Registry\u2013India, #CTRI\/2017\/06\/008908<\/jats:ext-link>; Registered on: 23\/06\/2017, (http:\/\/ctri.nic.in\/Clinicaltrials\/pmaindet2.php?trialid=19339&EncHid=&userName=society%20for%20applied%20studies<\/jats:ext-link>).<\/jats:p>","DOI":"10.1371\/journal.pone.0282381","type":"journal-article","created":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T17:31:02Z","timestamp":1694626262000},"page":"e0282381","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Burden, risk factors and outcomes associated with adequately treated hypothyroidism in a population-based cohort of pregnant women from North India"],"prefix":"10.1371","volume":"18","author":[{"given":"Neeta","family":"Dhabhai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0055-6653","authenticated-orcid":true,"given":"Ranadip","family":"Chowdhury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anju","family":"Virmani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritu","family":"Chaudhary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunita","family":"Taneja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratima","family":"Mittal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupali","family":"Dewan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Dang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Kaur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nita","family":"Bhandari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,9,13]]},"reference":[{"issue":"1","key":"pone.0282381.ref001","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1186\/s12884-020-03448-z","article-title":"Study of thyroid function in pregnancy, its feto-maternal outcome; 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International Fetal and Newborn Growth Consortium for the 21st Century, or INTERGROWTH-21st."},{"issue":"1","key":"pone.0282381.ref018","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s12902-021-00699-5","article-title":"Levothyroxine and the risk of adverse pregnancy outcomes in women with subclinical hypothyroidism: a systematic review and meta-analysis.","volume":"21","author":"M Bein","year":"2021","journal-title":"BMC endocrine disorders"},{"issue":"2","key":"pone.0282381.ref019","first-page":"e6938","article-title":"Pregnancy Outcomes among Obese Pregnant Women with Hypothyroidism: Medical Record Review of a Single Tertiary Center in Saudi Arabia","volume":"12","author":"AM Fallatah","year":"2020","journal-title":"Cureus"},{"issue":"6","key":"pone.0282381.ref020","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1111\/cen.13412","article-title":"Maternal thyroid function, prepregnancy obesity and gestational weight gain-The Generation R Study: A prospective cohort study","volume":"87","author":"FM Collares","year":"2017","journal-title":"Clinical endocrinology"},{"key":"pone.0282381.ref021","doi-asserted-by":"crossref","first-page":"2349","DOI":"10.3389\/fimmu.2019.02349","article-title":"The Impact of Obesity on Thyroid Autoimmunity and Dysfunction: A Systematic Review and Meta-Analysis.","volume":"10","author":"RH Song","year":"2019","journal-title":"Frontiers in immunology"},{"issue":"4","key":"pone.0282381.ref022","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.18203\/2320-1770.ijrcog20181360","article-title":"Prevalence of hypothyroidism amongst pregnant women: a study done in rural set up.","volume":"7","author":"NS Pillai","year":"2018","journal-title":"International Journal of Reproduction, Contraception, Obstetrics and Gynecology."},{"key":"pone.0282381.ref023","doi-asserted-by":"crossref","first-page":"629831","DOI":"10.3389\/fendo.2021.629831","article-title":"Iron Deficiency, a Risk Factor of Thyroid Disorders in Reproductive-Age and Pregnant Women: A Systematic Review and Meta-Analysis.","volume":"12","author":"J Luo","year":"2021","journal-title":"Frontiers in endocrinology"},{"key":"pone.0282381.ref024","doi-asserted-by":"crossref","first-page":"772917","DOI":"10.3389\/fendo.2021.772917","article-title":"Mild Anemia May Affect Thyroid Function in Pregnant Chinese Women During the First Trimester.","volume":"12","author":"GY Nie","year":"2021","journal-title":"Frontiers in endocrinology"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0282381","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T17:32:46Z","timestamp":1694626366000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0282381"}},"subtitle":[],"editor":[{"given":"Surangi","family":"Jayakody","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,9,13]]},"references-count":24,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0282381","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,13]]}}}