Harmful effects of hypothyroidism on maternal and fetal health drive new guidelines for managing thyroid disease in preg

July 25, 2011

Emerging data clarifying the risks of insufficient thyroid activity during pregnancy on the health of the mother and fetus, and on the future intellectual development of the child, have led to new clinical guidelines for diagnosing and managing thyroid disease during this critical period. The guidelines, developed by an American Thyroid Association (ATA) expert task force, are presented in Thyroid.

Clinical studies are producing critical data demonstrating the harmful effects not only of overt and on pregnancy, but also of subclinical disease and maternal and fetal health. Ongoing research is clarifying the link between miscarriage and preterm delivery in women with normal who are thyroid peroxidase antibody positive. Studies are also uncovering the long-term effects of postpartum thyroiditis.

"Pregnancy has a profound impact on the and thyroid function…. In essence, pregnancy is a stress test for the thyroid, resulting in hypothyroidism in women with limited thyroidal reserve or iodine deficiency," state Alex Stagnaro-Green, George Washington University School of Medicine and Health Sciences (Washington, DC), and coauthors representing the ATA task force.

Among the many specific recommendations detailed in the guidelines are the following: women with overt hypothyroidism or with subclinical hypothyroidism who are TPO antibody positive should be treated with oral levothyroxine; use of other thyroid preparations such as triiodothyronine or desiccated thyroid to treat maternal hypothyroidism is strongly recommended against; and women with subclinical hypothyroidism in pregnancy who are not initially treated should be monitored for progression to overt hypothyroidism with serum TSH and free T4 measurements about every 4 weeks until 16-20 weeks gestation and at least once between 26-32 weeks gestation.

The new clinical guidelines focus on several key areas in the diagnosis and management of thyroid disease during pregnancy and postpartum: thyroid function tests, hypothyroidism, thyrotoxicosis, iodine, thyroid antibodies and miscarriage/, thyroid nodules and cancer, postpartum thyroiditis, recommendations on screening for thyroid disease during pregnancy, and areas for future research.

"These important guidelines were developed by a panel of international experts representing the disciplines of endocrinology, obstetrics and gynecology, and nurse midwives. This broad representation of providers that care for pregnant women will significantly increase the impact of these guidelines and translation of findings from the most recent research to clinical practice," says Gregory A. Brent, MD, Professor of Medicine and Physiology, David Geffen School of Medicine at the University of California Los Angeles and President of the ATA.

" in pregnancy is common, clinically important, and time-sensitive, and our knowledge about it is rapidly changing. This ATA Guideline will disseminate this new information both widely and rapidly to improve patient care, establish what we believe is optimal care for the pregnant woman and her unborn child, and drive future research to further improve our understanding and patient outcomes," says Richard T. Kloos, MD, Professor, The Ohio State University and Secretary/Chief Operating Officer of the ATA.

Explore further: BMC conducts high rates of thyroid testing in pregnant women, study finds

More information: www.liebertpub.com/thy

Related Stories

BMC conducts high rates of thyroid testing in pregnant women, study finds

June 30, 2011
A recent study completed by researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) demonstrates that BMC conducts a high rate of thyroid function testing in pregnant women. The retrospective ...

New guidelines for diagnosis and management of hyperthyroid

June 13, 2011
New clinical guidelines developed by an expert panel that include 100 evidence-based recommendations for optimal care of patients with hyperthyroidism and other causes of thyrotoxicosis are presented in the current issue ...

Recommended for you

Mind-body therapies immediately reduce unmanageable pain in hospital patients

July 25, 2017
Mindfulness training and hypnotic suggestion significantly reduced acute pain experienced by hospital patients, according to a new study published in the Journal of General Internal Medicine.

Researchers report new system to study chronic hepatitis B

July 25, 2017
Scientists from Princeton University's Department of Molecular Biology have successfully tested a cell-culture system that will allow researchers to perform laboratory-based studies of long-term hepatitis B virus (HBV) infections. ...

Research examines lung cell turnover as risk factor and target for treatment of influenza pneumonia

July 24, 2017
Influenza is a recurring global health threat that, according to the World Health Organization, is responsible for as many as 500,000 deaths every year, most due to influenza pneumonia, or viral pneumonia. Infection with ...

Scientists propose novel therapy to lessen risk of obesity-linked disease

July 24, 2017
With obesity related illnesses a global pandemic, researchers propose in the Journal of Clinical Investigation using a blood thinner to target molecular drivers of chronic metabolic inflammation in people eating high-fat ...

Raccoon roundworm—a hidden human parasite?

July 24, 2017
The raccoon that topples your trashcan and pillages your garden may leave more than just a mess. More likely than not, it also contaminates your yard with parasites—most notably, raccoon roundworms (Baylisascaris procyonis).

Google searches can be used to track dengue in underdeveloped countries

July 20, 2017
An analytical tool that combines Google search data with government-provided clinical data can quickly and accurately track dengue fever in less-developed countries, according to new research published in PLOS Computational ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.