Endocrine and Metabolic Predictors of Adverse Pregnancy Outcomes in Women with Autoimmune Thyroiditis

Autoimmune thyroiditis (AIT) is one of the most common endocrine disorders in women of reproductive age and is associated with a high risk of metabolic disturbances and adverse pregnancy outcomes. The aim of the present study was to evaluate endocrine and metabolic predictors of unfavorable gestational and perinatal outcomes in pregnant women with autoimmune thyroiditis, hypothyroidism, and obesity. A prospective comparative clinical study was conducted involving 120 pregnant women divided into a main group consisting of women with autoimmune thyroiditis, hypothyroidism, and obesity, and a control group of healthy pregnant women. Comprehensive clinical, hormonal, biochemical, and ultrasound examinations were performed, including assessment of thyroid-stimulating hormone, free thyroxine, anti-thyroid peroxidase antibodies, selenium, vitamin D, calcium, lipid profile, and glucose metabolism parameters. The study demonstrated that women with autoimmune thyroiditis had significant endocrine and metabolic abnormalities characterized by elevated TSH levels, reduced free thyroxine concentrations, obesity, dyslipidemia, insulin resistance, and micronutrient deficiencies. These disturbances were associated with a significantly increased frequency of threatened miscarriage, preeclampsia, placental insufficiency, preterm birth, fetal growth restriction, and impaired neonatal adaptation. The findings confirm that autoimmune thyroiditis should be considered a multifactorial systemic disorder affecting both maternal metabolism and pregnancy outcomes. Early diagnosis of thyroid dysfunction and metabolic imbalance, together with personalized management and micronutrient correction, may improve obstetric and perinatal outcomes in women with autoimmune thyroid disease.

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