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Introduction Subclinical hypothyroidism (SCH) during early pregnancy is associated with an increased risk of miscarriage or premature birth. In Pakistan, the prevalence of SCH among pregnant women is not well documented. This multi-center study aims at identifying the prevalence of SCH among Pakistani pregnant women. Methods A cross-sectional multi-center study was conducted over a period of 12 months. Pregnant females in the first trimester of pregnancy were recruited from the antenatal clinics of seven centers from six Pakistani cities. We assessed the frequency of SCH in pregnant females and associated risk factors. Results A total of 500 pregnant women were enrolled in this study. Only eight women (1.6%) had a newly-diagnosed SCH. While 1.2% of women had hyperthyroidism, 6% had known hypothyroidism, and 1% had overt hypothyroidism. Ten females (33.3%) with known hypothyroidism were receiving an inadequate dose of thyroid replacement therapy. The association between BMI and SCH was not statistically significant (p = 0.69). Moreover, we could not find any significant difference between patients with or without SCH in terms of age (p > 0.90), dyslipidemia (p = 0.157), history of miscarriage (p > 0.90), the regularity of the cycle (p > 0.90), and history of infertility (p > 0.90). Conclusions The frequency of undiagnosed SCH in pregnant females in the study from Pakistan was 1.6%. The rate of uncontrolled hypothyroidism was high, which raises an alarm of the potential risks of untreated thyroid disorder.
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OBJECTIVE: To describe the frequency of low Bone Mineral Density (BMD) in perimenopausal and postmenopausal women. METHODS: Middle to old aged women from two teaching hospitals of Peshawar were included in the study. They were divided into four age groups, 40-49 years, 50-59 years, 60-69 years and 70 years and above. There was no history of any drug use for bone loss. BMD was measured at the heel by ultrasonography and main outcome measures were in the form of baseline T-Scores. RESULTS: Of the 608 women studied, 35.03% were in the age group 40-49 years, 34.87% in 50-59 years, 22.7% in 60-69 years and 7.4% were 70 years or older. Using WHO criteria, 35.36% of women had osteopenia (T-Score-1 to-2.49) and 12.01% had osteoporosis (T-Square < -2.5). The frequency of decreased BMD increased significantly with increasing age (P<0.000). Osteoporosis was present in 9.59% in the age group of 40-49 years, and it increased to 36.99% in patients aged 60-69 years and 23.29% in age group of 70 years and above. Within a single age group the number of women with osteopenia and osteoporosis was significantly high e.g. in age group of 70 years and above only 20% of subjects had normal BMD whereas 80% had low BMD. CONCLUSION: Almost half of the sample population had decreased BMD. Peri and postmenopausal women constitute a high-risk group for osteoporosis and future fractures.