Interní Med. 2011; 13(10): 388-390

Thyroid disorders in pregnancy

prof.MUDr.Jiří Horáček, CSc.
II. interní klinika LF UK a FN v Hradci Králové

There is an increased need for thyroid hormones in pregnancy, and normal thyroid increases their synthesis in compensation. In the

terrain of chronic autoimmune thyroiditis, such a compensation may be absent, and the resulting hypothyroidism (even subclinical),

and even the autoimmune process itself, may adversely affect the pregnancy course and outcome, maternal quality of life, as well as

neurological development of the offspring. At least some of these risks are reversible by levothyroxine treatment. Therefore, we recommend

universal screening of thyroid disorders in early pregnancy using TSH and TPO-Ab assays.

Keywords: pregnancy, hypothyroidism, autoimmune thyroiditis, postpartum thyroiditis

Published: October 1, 2011  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Horáček J. Thyroid disorders in pregnancy. Interní Med. 2011;13(10):388-390.
Download citation

References

  1. Glinoer D. The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocrine Rev 1997; 18: 404-433. Go to original source... Go to PubMed...
  2. Límanová Z. Onemocnění štítné žlázy v graviditě. In: Límanová Z, a kol. Štítná žláza. Praha: Galén 2006: 179-193.
  3. Zamrazil V, Bilek R, Cerovska J, Delange F. The elimination of iodine deficiency in the Czech Republic: the steps toward success. Thyroid 2004; 14: 49-56. Go to original source... Go to PubMed...
  4. Zamrazil V, Bílek R, Čeřovská J, et al. Jodový deficit ve světě i v České republice - současný stav a perspektivy. Vnitř Lék 2010; 56(12): 1310-1315. Go to PubMed...
  5. Mandel SJ, Spencer CA, Hollowell JG. Are detection and treatment of thyroid insufficiency in pregnancy feasible? Thyroid 2005; 15: 44-53. Go to original source... Go to PubMed...
  6. Springer D, Zima T, Limanova Z. Reference intervals in evaluation of maternal thyroid function during the first trimester of pregnancy. Eur J Endocrinol 2009; 160: 791-797. Go to original source... Go to PubMed...
  7. Abalovich M, Amino N, Barbour LA, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2007; 92(8): S1-S47. Go to original source... Go to PubMed...
  8. Casey BM, Dashe JS, Wells CE, et al. Subclinical hyperthyroidism and pregnancy outcomes. Obstet Gynecol 2006; 107(2 Pt 1): 337-341. Go to original source... Go to PubMed...
  9. Benhadi N, Wiersinga WM, Reitsma JB, et al. Higher maternal TSH levels in pregnancy are associated with increased risk for miscarriage, fetal and neonatal death. Eur J Endocrinol 2009; 160: 985-991. Go to original source... Go to PubMed...
  10. Männistö T, Vääräsmäki M, Pouta A, et al. Perinatal outcome of children born to mothers with thyroid dysfunction or antibodies: a prospective population-based cohort study. J Clin Endocrinol Metab 2009; 94(3): 772-779. Go to original source... Go to PubMed...
  11. Negro R, Scwhwartz A, Gismondi R, et al. Universal screening versus case finding for detection and treatment of thyroid hormonal dysfunction during pregnancy. J Clin Endocrinol Metab 2010; 95: 1699-1707. Go to original source... Go to PubMed...
  12. Haddow JE, Palomaki GE, Allan WC, et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. New Engl J Med 1999; 341: 549-555. Go to original source... Go to PubMed...
  13. Pop V, Brouwers EP, Vader HL, et al. Maternal hypothyroxinaemia during early pregnancy and subsequent child development: a 3-year follow-up study. Clin Endocrinol 2003; 59: 282-288. Go to original source... Go to PubMed...
  14. Negro R, Formoso G, Mangieri T, et al. Levothyroxine treatment in euthyroid pregnant women with autoimmune thyroid disease: effects on obstetrical complications. J Clin Endocrinol Metab 2006; 91(7): 2587-2591. Go to original source... Go to PubMed...
  15. Stagnaro-Green A, Schwartz A, Gismondi R, et al. High rate of persistent hypothyroidism in a large-scale prospective study of postpartum thyroidits in southern Italy. J Clin Endocrinol Metab 2011; 96: 652-657. Go to original source... Go to PubMed...
  16. Alexander EK. Here's to you, baby! A step forward in support of universal screening of thyroid function during pregnancy. J Clin Endocrinol Metab 2010; 95: 1575-1577. Go to original source... Go to PubMed...
  17. Horacek J, Spitalnikova S, Dlabalova B, et al. Universal screening detects two-times more thyroid disorders in early pregnancy than targeted high-risk case finding. Eur J Endocrinol 2010; 163: 645-650. Go to original source... Go to PubMed...
  18. Jiskra J, Límanová Z, Potluková E, et al. Význam skríninku tyreopatií u těhotných žen: patofyziologický podklad a praktické aspekty. Čas Lék Čes 2007; 146(11): 827-833.
  19. Vaidya B, Anthony S, Bilous M, et al. Detection of Thyroid Dysfunction in Early Pregnancy: Universal screening or targeted high-risk case finding? J Clin Endocrinol Metab 2007; 92(1): 203-207. Go to original source... Go to PubMed...
  20. Alexander EK, Marqusee E, Lawrence J, et al. Timing and magnitude of increases in levothyroxine requirements during pregnancy in women with hypothyroidism. New Engl J Med 2004; 351: 349-353. Go to original source... Go to PubMed...




Internal Medicine for Practice

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.