The Level of Thyroid Stimulating Hormone, Thyroxine, Free Thyroxine, Triiodothyronine, Free Triiodothyronine, and Prolactin among Breastfeeding Women from Baghdad city: A Case–Control Study
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Abstract
Background: The postpartum period involves a multitude of adaptations, both endocrine
and metabolic, allowing the mother to lactate successfully while recovering from
parturition. Changes in the action of thyroid hormones during lactation might have a
substantial effect on physiology for mothers as well as on lactational performance. Despite
this growing awareness of postpartum thyroid disease, the relationship between lactation
and thyroid hormone homeostasis has not yet been fully elucidated.
Objective: To examine serum levels of thyroid stimulating hormone (TSH), total
thyroxine (T4), free thyroxine (FT4), total triiodothyronine(T3), free triiodothyronine
(FT3) and prolactin in breastfeeding women compared to healthy controls.
Methods: In this case–control study, we conducted a survey in Baghdad, Iraq between
February 2025 and May 2026. Fifty breastfeeding women aged 25–43 years were recruited
along with forty healthy females matched for age and body mass index to act as controls.
Exclusion criteria included history of diabetes mellitus (28) or renal disorder Fasting
venous blood samples were taken. Hormonal analyses were done using the vendor
specified Enzyme-linked immunosorbent assay (ELISA) methods. Statistical analyses
used were Student′s t-test and Pearson correlation analysis.
Results: Serum TSH and prolactin levels in breastfeeding women were significantly
higher than those of controls (p < 0.01). In contrast, the lactating participants showed
significant reductions of total and free thyroid hormone concentrations. Positive
correlations were seen between prolactin and TSH concentrations, while inverse
correlations were found with the parameters of prolactin with T3/T4 using correlation
analysis.
Conclusion: the assessment of thyroid function during lactation is very important to
optimize maternal healthcare and breastfeeding outcomes.