Advanced search
Publication Cover
Expert Review of Endocrinology & Metabolism Volume 8, 2013 - Issue 6
Submit an article Journal homepage
100
Views
2
CrossRef citations to date
0
Altmetric
Reviews

Thyroid disease during pregnancy: options for management

Tuija MännistöNational Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD, 20852, USACorrespondence[email protected]
Pages 537-547 | Published online: 10 Jan 2014

References

  • Glinoer D, De NP, Bourdoux P et al. Regulation of maternal thyroid during pregnancy. J. Clin. Endocrinol. Metab. 71(2), 276–287 (1990).
  • Stagnaro-Green A, Abalovich M, Alexander E et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum. Thyroid 21(10), 1081–1125 (2011).
  • Bahn RS, Burch HB, Cooper DS et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American thyroid association and American association of clinical endocrinologists. Endocr. Pract. 17(3), 456–520 (2011).
  • Garber JR, Cobin RH, Gharib H et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American association of clinical endocrinologists and the American thyroid association. Thyroid 22(12), 1200–1235 (2012).
  • De Groot LJ, Abalovich M, Alexander EK et al. Management of thyroid dysfunction during pregnancy and postpartum: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 97(8), 2543–2565 (2012).
  • Boas M, Forman JL, Juul A et al. Narrow intra-individual variation of maternal thyroid function in pregnancy based on a longitudinal study on 132 women. Eur. J. Endocrinol. 161(6), 903–910 (2009).
  • Larsson A, Palm M, Hansson LO, Axelsson O. Reference values for clinical chemistry tests during normal pregnancy. BJOG 115(7), 874–881 (2008).
  • Männistö T, Surcel HM, Ruokonen A et al. Early pregnancy reference intervals of thyroid hormone concentrations in a thyroid antibody-negative pregnant population. Thyroid 21(3), 291–298 (2011).
  • Yu X, Chen Y, Shan Z et al. The pattern of thyroid function of subclinical hypothyroid women with levothyroxine treatment during pregnancy. Endocrine doi:10.1007/s12020-013-9913-2 (2013) (Epub ahead of print).
  • Van Houcke SK, Van Uytfanghe K, Shimizu E et al. IFCC international conventional reference procedure for the measurement of free thyroxine in serum: international federation of clinical chemistry and laboratory medicine (IFCC) working group for standardization of thyroid function tests (WG-STFT)(1). Clin. Chem. Lab. Med. 49(8), 1275–1281 (2011).
  • Sapin R, D'Herbomez M. Free thyroxine measured by equilibrium dialysis and nine immunoassays in sera with various serum thyroxine-binding capacities. Clin. Chem. 49(9), 1531–1535 (2003).
  • Midgley JE, Hoermann R. Measurement of total rather than free thyroxine in pregnancy: the diagnostic implications. Thyroid 23(3), 259–261 (2013).
  • Abalovich M, Gutierrez S, Alcaraz G et al. Overt and subclinical hypothyroidism complicating pregnancy. Thyroid 12(1), 63–68 (2002).
  • Allan WC, Haddow JE, Palomaki GE et al. Maternal thyroid deficiency and pregnancy complications: implications for population screening. J. Med. Screen. 7(3), 127–130 (2000).
  • Ashoor G, Maiz N, Rotas M, Jawdat F, Nicolaides KH. Maternal thyroid function at 11 to 13 weeks of gestation and subsequent fetal death. Thyroid. 20(9), 989–993 (2010).
  • Benhadi N, Wiersinga WM, Reitsma JB, Vrijkotte TG, Bonsel GJ. Higher maternal TSH levels in pregnancy are associated with increased risk for miscarriage, fetal or neonatal death. Eur. J. Endocrinol. 160(6), 985–991 (2009).
  • Negro R, Schwartz A, Gismondi R et al. Increased pregnancy loss rate in thyroid antibody negative women with TSH levels between 2.5 and 5.0 in the first trimester of pregnancy. J. Clin. Endocrinol. Metab. 95(9), E44–E48 (2010).
  • Sahu MT, Das V, Mittal S, Agarwal A, Sahu M. Overt and subclinical thyroid dysfunction among Indian pregnant women and its effect on maternal and fetal outcome. Arch. Gynecol. Obstet. 281(2), 215–220 (2010).
  • Schneuer FJ, Nassar N, Tasevski V, Morris JM, Roberts CL. Association and predictive accuracy of high TSH serum levels in first trimester and adverse pregnancy outcomes. J. Clin. Endocrinol. Metab. 97(9), 3115–3122 (2012).
  • Su PY, Huang K, Hao JH et al. Maternal thyroid function in the first twenty weeks of pregnancy and subsequent fetal and infant development: a prospective population-based cohort study in China. J. Clin. Endocrinol. Metab. 96(10), 3234–3241 (2011).
  • Ashoor G, Maiz N, Rotas M, Kametas NA, Nicolaides KH. Maternal thyroid function at 11 to 13 weeks of gestation and subsequent development of preeclampsia. Prenat. Diagn. 30(11), 1032–1038 (2010).
  • Davis LE, Leveno KJ, Cunningham FG. Hypothyroidism complicating pregnancy. Obstet. Gynecol. 72(1), 108–112 (1988).
  • Leung AS, Millar LK, Koonings PP, Montoro M, Mestman JH. Perinatal outcome in hypothyroid pregnancies. Obstet. Gynecol. 81(3), 349–353 (1993).
  • Wilson KL, Casey BM, McIntire DD, Halvorson LM, Cunningham FG. Subclinical thyroid disease and the incidence of hypertension in pregnancy. Obstet. Gynecol. 119(2 Pt 1), 315–320 (2012).
  • Casey BM, Dashe JS, Spong CY et al. Perinatal significance of isolated maternal hypothyroxinemia identified in the first half of pregnancy. Obstet. Gynecol. 109(5), 1129–1135 (2007).
  • Jones WS, Man EB. Thyroid function in human pregnancy. VI. Premature deliveries and reproductive failures of pregnant women with low serum butanol-extractable iodines. Maternal serum TBG and TBPA capacities. Am. J. Obstet. Gynecol. 104(6), 909–914 (1969).
  • Casey BM, Dashe JS, Wells CE et al. Subclinical hypothyroidism and pregnancy outcomes. Obstet. Gynecol. 105(2), 239–245 (2005).
  • Stagnaro-Green A, Chen X, Bogden JD, Davies TF, Scholl TO. The thyroid and pregnancy: a novel risk factor for very preterm delivery. Thyroid 15(4), 351–357 (2005).
  • Haddow JE, Palomaki GE, Allan WC et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N. Engl. J. Med. 341(8), 549–555 (1999).
  • Williams F, Watson J, Ogston S et al. Mild maternal thyroid dysfunction at delivery of infants born </=34 weeks and neurodevelopmental outcome at 5.5 years. J. Clin. Endocrinol. Metab. 97(6), 1977–1985 (2012).
  • Tudela CM, Casey BM, McIntire DD, Cunningham FG. Relationship of subclinical thyroid disease to the incidence of gestational diabetes. Obstet. Gynecol. 119(5), 983–988 (2012).
  • Kooistra L, Kuppens SM, Hasaart TH et al. High thyrotrophin levels at end term increase the risk of breech presentation. Clin. Endocrinol. (Oxf.) 73(5), 661–665 (2010).
  • Kuppens SM, Kooistra L, Wijnen HA et al. Maternal thyroid function during gestation is related to breech presentation at term. Clin. Endocrinol. (Oxf.) 72(6), 820–824 (2010).
  • Cleary-Goldman J, Malone FD, Lambert-Messerlian G et al. Maternal thyroid hypofunction and pregnancy outcome. Obstet. Gynecol. 112(1), 85–92 (2008).
  • 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. 94(3), 772–779 (2009).
  • Männistö T, Vääräsmäki M, Pouta A et al. Thyroid dysfunction and autoantibodies during pregnancy as predictive factors of pregnancy complications and maternal morbidity in later life. J. Clin. Endocrinol. Metab. 95(3), 1084–1094 (2010).
  • Ashoor G, Maiz N, Rotas M, Jawdat F, Nicolaides KH. Maternal thyroid function at 11-13 weeks of gestation and spontaneous preterm delivery. Obstet. Gynecol. 117(2 Pt 1), 293–298 (2011).
  • Karagiannis G, Ashoor G, Maiz N, Jawdat F, Nicolaides KH. Maternal thyroid function at eleven to thirteen weeks of gestation and subsequent delivery of small for gestational age neonates. Thyroid 21(10), 1127–1131 (2011).
  • Williams FL, Watson J, Ogston SA et al. Maternal and umbilical cord levels of T4, FT4, TSH, TPOAb, and TgAb in term infants and neurodevelopmental outcome at 5.5 years. J. Clin. Endocrinol. Metab. 98(2), 829–838 (2013).
  • Männistö T, Mendola P, Grewal J et al. Thyroid diseases and adverse pregnancy outcomes in a contemporary US cohort. J. Clin. Endocrinol. Metab. 98(7), 2725–2733 (2013).
  • Wikner BN, Sparre LS, Stiller CO, Kallen B, Asker C. Maternal use of thyroid hormones in pregnancy and neonatal outcome. Acta Obstet. Gynecol. Scand 87(6), 617–627 (2008).
  • Wolfberg AJ, Lee-Parritz A, Peller AJ, Lieberman ES. Obstetric and neonatal outcomes associated with maternal hypothyroid disease. J. Matern. Fetal Neonatal Med. 17(1), 35–38 (2005).
  • Männistö T, Mendola P, Reddy U, Laughon SK. Neonatal outcomes and birth weight in pregnancies complicated by maternal thyroid disease. Am. J. Epidemiol. 178(5), 731–740 (2013).
  • Idris I, Srinivasan R, Simm A, Page RC. Maternal hypothyroidism in early and late gestation: effects on neonatal and obstetric outcome. Clin. Endocrinol. (Oxf.) 63(5), 560–565 (2005).
  • Matalon S, Sheiner E, Levy A, Mazor M, Wiznitzer A. Relationship of treated maternal hypothyroidism and perinatal outcome. J. Reprod. Med. 51(1), 59–63 (2006).
  • Glinoer D, Riahi M, Grun JP, Kinthaert J. Risk of subclinical hypothyroidism in pregnant women with asymptomatic autoimmune thyroid disorders. J. Clin. Endocrinol. Metab. 79(1), 197–204 (1994).
  • Abalovich M, Vazquez A, Alcaraz G et al. Adequate levothyroxine doses for the treatment of hypothyroidism newly diagnosed during pregnancy. Thyroid doi:10.1089/thy.2013.0024 (2013) (Epub ahead of print).
  • Alexander EK, Marqusee E, Lawrence J et al. Timing and magnitude of increases in levothyroxine requirements during pregnancy in women with hypothyroidism. N. Engl. J. Med. 351(3), 241–249 (2004).
  • Yassa L, Marqusee E, Fawcett R, Alexander EK. Thyroid hormone early adjustment in pregnancy (the THERAPY) trial. J. Clin. Endocrinol. Metab. 95(7), 3234–3241 (2010).
  • Abalovich M, Alcaraz G, Kleiman-Rubinsztein J et al. The relationship of preconception thyrotropin levels to requirements for increasing the levothyroxine dose during pregnancy in women with primary hypothyroidism. Thyroid 20(10), 1175–1178 (2010).
  • Loh JA, Wartofsky L, Jonklaas J, Burman KD. The magnitude of increased levothyroxine requirements in hypothyroid pregnant women depends upon the etiology of the hypothyroidism. Thyroid 19(3), 269–275 (2009).
  • Verga U, Bergamaschi S, Cortelazzi D et al. Adjustment of L-T4 substitutive therapy in pregnant women with subclinical, overt or post-ablative hypothyroidism. Clin. Endocrinol. (Oxf.) 70(5), 798–802 (2009).
  • Vissenberg R, van den Boogaard E, van Wely M et al. Treatment of thyroid disorders before conception and in early pregnancy: a systematic review. Hum. Reprod. Update 18(4), 360–373 (2012).
  • Negro R, Schwartz A, Gismondi R et al. Universal screening versus case finding for detection and treatment of thyroid hormonal dysfunction during pregnancy. J. Clin. Endocrinol. Metab. 95(4), 1699–1707 (2010).
  • Lazarus JH, Bestwick JP, Channon S et al. Antenatal thyroid screening and childhood cognitive function. N. Engl. J. Med. 366(6), 493–501 (2012).
  • Kim CH, Ahn JW, Kang SP et al. Effect of levothyroxine treatment on in vitro fertilization and pregnancy outcome in infertile women with subclinical hypothyroidism undergoing in vitro fertilization/intracytoplasmic sperm injection. Fertil. Steril. 95(5), 1650–1654 (2011).
  • Michalakis KG, Mesen TB, Brayboy LM et al. Subclinical elevations of thyroid-stimulating hormone and assisted reproductive technology outcomes. Fertil. Steril. 95(8), 2634–2637 (2011).
  • Liwanpo L, Hershman JM. Conditions and drugs interfering with thyroxine absorption. Best Pract. Res. Clin. Endocrinol. Metab. 23(6), 781–792 (2009).
  • Blakesley V, Awni W, Locke C et al. Are bioequivalence studies of levothyroxine sodium formulations in euthyroid volunteers reliable? Thyroid 14(3), 191–200 (2004).
  • Hennessey JV. Generic vs name brand L-thyroxine products: interchangeable or still not? J. Clin. Endocrinol. Metab. 98(2), 511–514 (2013).
  • Hennessey JV, Malabanan AO, Haugen BR, Levy EG. Adverse event reporting in patients treated with levothyroxine: results of the pharmacovigilance task force survey of the American thyroid association, American association of clinical endocrinologists and the endocrine society. Endocr. Pract. 16(3), 357–370 (2010).
  • Mandel SJ, Larsen PR, Seely EW, Brent GA. Increased need for thyroxine during pregnancy in women with primary hypothyroidism. N. Engl. J. Med. 323(2), 91–96 (1990).
  • Galofre JC, Haber RS, Mitchell AA, Pessah R, Davies TF. Increased postpartum thyroxine replacement in Hashimoto's thyroiditis. Thyroid 20(8), 901–908 (2010).
  • Morreale de EG, Obregon MJ, Escobar del RF. Is neuropsychological development related to maternal hypothyroidism or to maternal hypothyroxinemia? J. Clin. Endocrinol. Metab. 85(11), 3975–3987 (2000).
  • Pop VJ, Kuijpens JL, van Baar AL et al. Low maternal free thyroxine concentrations during early pregnancy are associated with impaired psychomotor development in infancy. Clin. Endocrinol. (Oxf.) 50(2), 149–155 (1999).
  • Pop VJ, Brouwers EP, Vader HL et al. Maternal hypothyroxinaemia during early pregnancy and subsequent child development: a 3-year follow-up study. Clin. Endocrinol. (Oxf.) 59(3), 282–288 (2003).
  • Millar LK, Wing DA, Leung AS et al. Low birth weight and preeclampsia in pregnancies complicated by hyperthyroidism. Obstet. Gynecol. 84(6), 946–949 (1994).
  • Phoojaroenchanachai M, Sriussadaporn S, Peerapatdit T et al. Effect of maternal hyperthyroidism during late pregnancy on the risk of neonatal low birth weight. Clin. Endocrinol. (Oxf.) 54(3), 365–370 (2001).
  • Sheffield JS, Cunningham FG. Thyrotoxicosis and heart failure that complicate pregnancy. Am. J. Obstet. Gynecol. 190(1), 211–217 (2004).
  • Luewan S, Chakkabut P, Tongsong T. Outcomes of pregnancy complicated with hyperthyroidism: a cohort study. Arch. Gynecol. Obstet. 283(2), 243–247 (2011).
  • Chen CH, Xirasagar S, Lin CC et al. Risk of adverse perinatal outcomes with antithyroid treatment during pregnancy: a nationwide population-based study. BJOG 118(11), 1365–1373 (2011).
  • Casey BM, Dashe JS, Wells CE et al. Subclinical hyperthyroidism and pregnancy outcomes. Obstet. Gynecol. 107(2 Pt 1), 337–341 (2006).
  • Yoshihara A, Noh J, Yamaguchi T et al. Treatment of graves' disease with antithyroid drugs in the first trimester of pregnancy and the prevalence of congenital malformation. J. Clin. Endocrinol. Metab. 97(7), 2396–2403 (2012).
  • 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. 91(7), 2587–2591 (2006).
  • Lepoutre T, Debieve F, Gruson D, Daumerie C. Reduction of miscarriages through universal screening and treatment of thyroid autoimmune diseases. Gynecol. Obstet. Invest. 74(4), 265–273 (2012).
  • Stagnaro-Green A, Roman SH, Cobin RH et al. Detection of at-risk pregnancy by means of highly sensitive assays for thyroid autoantibodies. JAMA 264(11), 1422–1425 (1990).
  • Thangaratinam S, Tan A, Knox E et al. Association between thyroid autoantibodies and miscarriage and preterm birth: meta-analysis of evidence. BMJ 342, d2616 (2011).
  • Negro R, Mangieri T, Coppola L et al. Levothyroxine treatment in thyroid peroxidase antibody-positive women undergoing assisted reproduction technologies: a prospective study. Hum. Reprod. 20(6), 1529–1533 (2005).
  • Abbassi-Ghanavati M, Casey BM, Spong CY et al. Pregnancy outcomes in women with thyroid peroxidase antibodies. Obstet. Gynecol. 116(2 Pt 1), 381–386 (2010).
  • Negro R, Schwartz A, Gismondi R et al. Thyroid antibody positivity in the first trimester of pregnancy is associated with negative pregnancy outcomes. J. Clin. Endocrinol. Metab. 96(6), E920–E924 (2011).
  • Ghassabian A, Bongers-Schokking JJ, de Rijke YB et al. Maternal thyroid autoimmunity during pregnancy and the risk of attention deficit/hyperactivity problems in children: the generation R study. Thyroid 22(2), 178–186 (2012).
  • Negro R, Formoso G, Coppola L et al. Euthyroid women with autoimmune disease undergoing assisted reproduction technologies: the role of autoimmunity and thyroid function. J. Endocrinol. Invest. 30(1), 3–8 (2007).
  • Turi A, Giannubilo SR, Zanconi S, Mascetti A, Tranquilli AL. Preconception steroid treatment in infertile women with antithyroid autoimmunity undergoing ovarian stimulation and intrauterine insemination: a double-blind, randomized, prospective cohort study. Clin. Ther. 32(14), 2415–2421 (2010).
  • Stagnaro-Green A. Clinical review 152: postpartum thyroiditis. J. Clin. Endocrinol. Metab. 87(9), 4042–4047 (2002).
  • Cooper DS, Doherty GM, Haugen BR et al. Revised American thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19(11), 1167–1214 (2009).

Website

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Order Reprints Request Corporate Permissions

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

Request Academic Permissions

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.

Related research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.