Association of thyroid status with hemoglobin levels in pregnancy

Manisha Baghel, Jyoti Batra, Thimmaraju K. V., Maliyanar Itagappa


Background: The association of hemoglobin levels with thyroid status in pregnancy was not studied in detail. Therefore, in this study, we assessed the levels of hemoglobin, thyroid function and its association with hemoglobin levels in first trimester of pregnancy.

Methods: Fifty pregnant women who didn’t start any supplementation were recruited from the obstetrics and gynecology outpatient department. Fifty age matched controls were recruited from the residents and staff of the hospital.  Thyroid profile and hemoglobin levels were measured in both the groups. The association was seen between hemoglobin levels and thyroid stimulating hormone (TSH) levels.

Results: The hemoglobin levels are significantly low in first trimester pregnant women. Further, the increased TSH levels are negatively correlated with low hemoglobin levels.

Conclusions: Screening of hemoglobin levels in first trimester itself will be beneficial to prevent the complications of pregnancy. Further, hypothyroidism also present and associated with reduced hemoglobin. So, early diagnosis of these deficiencies will be useful to start giving supplements to avoid unwanted effects in pregnancy.


Hemoglobin, First trimester of pregnancy, Thyroid stimulating hormone

Full Text:



Strachan MWJ, Newell-Price J. Endocrine disease. In Davidson Principles and Practice of Medicine, 22nd ed.; Walker, B.R., Ed.; Churchill Livingstone: Edinburgh, UK;2014:738-740.

Rajput R, Goel V, Nanda S, Rajput M, Seth S. Prevalence of thyroid dysfunction among women during the first trimester of pregnancy at a tertiary care hospital in Haryana. Indian J Endocrinol. 2015;19416-9.

Klein RZ, Haddow JE, Faix JD, Brown RS, Hermos RJ, Pulkkinen A, Mitchell ML. Prevalence of thyroid deficiency in pregnant women. Clin Endocrinol. 1991;35:41-46.

Lazzarus J. Thyroid regulation and dysfunction in the pregnant patient. Available at (accessed on 8 April 2017).

Jameson JL, Weetman AP. Disorders of the thyroid gland. In Harrison Principles of Internal Medicine, 17th ed.; Fauci, A.S., Ed.; Mc Graw Hill: New York, NY, USA;2008:2224-9.

Mannisto T, Vaarasmaki M, Pouta A, Hartikainen AL, Ruokonen A, Surcel HM et al. Thyroid dysfunction and autoantibodies during pregnancy as predictive factors of pregnancy complications and maternal morbidity in later life. J Clin Endocrinol. 2010;95:1084-94.

Matalon S, Sheiner E, Levy A, Mazor M, Wiznitzer A. Relationship of treated maternal hypothyroidism and perinatal outcome. J Reprod Med. 2006;51:59-63.

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 Oct 1;21(10):1081-125.

Arlappa N, Laxmaiah A, Balakrishna N, Harikumar R, Kodavanti MR, Reddy CG et al. Micronutrient deficiency disorders among the rural children of West Bengal, India. Ann Hum Biol. 2011;38(3):281-9.

Pucci E, Chiovato L, Pinchera A. Thyroid and lipid metabolism. Int J Obestet Relat Metab Disord. 2000;24 Suppl 2:S109-12.

Kapil U. Health consequences of iodine deficiency. Sultan Qaboos Univ Med J. 2007;7(3):267-72.

Khatiwada S, Gelal B, Gautam S, Tamang MK, Shakya PR, Lamsal M et al. Anemia among school children in eastern Nepal. J Trop Pediatr. 2015;61(3):231-3.

World Health Organization. Assessing the iron status of populations. 2 nd Ed. Geneva, Switzerland: World Health Organization/Centers for Disease Control and Prevention Technical Consultation on the Assessment of Iron Status at the Population Level; 2004. Available at micronutrients/anaemia_iron_deficiency/9789241596107.pdf.

Teng W, Shan Z, Patil-Sisodia K, Cooper DS. Hypothyroidism in pregnancy. Lancet Diabetes Endocrinol. 2013;1(3):228-37.

Centers for Disease Control and Prevention. Pregnancy nutrition surveillance, 1996 full report. Atlanta: US Department of Health and Human Services, 1998.

United States Preventive Services Task Force. Screening for iron deficiency anemia-including iron prophylaxis. In: Guide to clinical preventive services. 2nd ed. Alexandria, Virginia: International Medical Publishing; 1996:231-46.

Garn SM, Ridella SA, Petzold AS, Falkner F. Maternal hematological levels and pregnancy outcomes. Semin Perinatol. 1981;5:155-62.

Lu ZM, Goldenberg RL, Cliver SP, Cutter G, Blankson ML. The relationship between maternal hematocrit and pregnancy outcome. Obstet Gynecol. 1991;71:190-4.

CDC criteria for anemia in children and childbearing-aged women. MMWR Morb Mortal Wkly Rep. 1989;38:400-4.