Physiological Changes in Thyroid Function Tests in Women with Silent Miscarriage

Abstract

Silent miscarriage is a type of miscarriage in which the fetus has died but has not been naturally expelled from the uterus, and it can result in maternal morbidity. This study was conducted to determine the physiological changes in thyroid function tests and progesterone in women with silent miscarriage; to evaluate the role of these parameters in the diagnosis of silent miscarriage; and to assess the impact of maternal and gestational age as well as family history. The study involved 96 women: 46 healthy pregnant women as controls and 50 women with silent miscarriage. We evaluated thyroid function tests (thyroid-stimulating hormone TSH, thyroxine T4, triiodothyronine T3) and progesterone P4 levels. Additional analyses were performed between silent miscarriage women subgroups based on gestational age, maternal age, and family history. Women who had miscarried often showed elevated TSH and decreased thyroid hormones (T4, T3) and progesterone levels compared to healthy pregnancies. A subanalysis of the miscarried women group revealed a significant increase in thyroid function profile and progesterone in the 2nd trimester. Miscarried women with a positive family history of miscarriage had significantly lower levels than those without a family history. Lastly, no age-related differences were observed for any of the parameters. Thyroid dysfunction and decreased progesterone levels were significantly associated with silent miscarriage, and gestational age and family history were associated with the severity of these abnormalities.