**6. Conclusion**

More and more evidences worldwide have pointed towards anti TPO antibody to be associated with clinical and subclinical hypothyroidism with adverse obstetric and fetal outcomes. As the management differs for subclinical hypothyroidism in anti TPO antibody positive and negative pregnant women hence more studies should be undertaken pertinent to different geographical areas regarding the prevalence of autoantibodies and their effect on pregnancy and on the off springs in the long term. The trimester specific reference ranges for different areas should also be specified with larger cohort of studies particularly for countries like India where there are wide geographical and ethnic variations. The area where there is severe lacking of data with respect to India is regarding the effects of autoimmune subclinical hypothyroidism on the obstetric, fetal outcomes and most importantly on the off springs in the long run. Hence, longer follow-up studies with larger cohorts is necessary to gather more evidences regarding this important endocrinal disorder in pregnancy in India.
