Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/24828
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Benign thyroid disease in pregnancy: A state of the art review
Authors: Tingi, Efterpi
Syed, Akheel A
Kyriacou, Alexis
Mastorakos, George
Kyriacou, Angelos
Contact Email: alexis.kyriacou@stir.ac.uk
Keywords: Pregnancy
Hyperthyroidism
Hypothyroidism
Thyroiditis
Autoimmune thyroid disease
Thioamides
Iodine
Issue Date: Dec-2016
Citation: Tingi E, Syed AA, Kyriacou A, Mastorakos G & Kyriacou A (2016) Benign thyroid disease in pregnancy: A state of the art review, Journal of Clinical and Translational Endocrinology, 6, pp. 37-49.
Abstract: Thyroid dysfunction is the commonest endocrine disorder in pregnancy apart from diabetes. Thyroid hormones are essential for fetal brain development in the embryonic phase. Maternal thyroid dysfunction during pregnancy may have significant adverse maternal and fetal outcomes such as preterm delivery, preeclampsia, miscarriage and low birth weight. In this review we discuss the effect of thyroid disease on pregnancy and the current evidence on the management of different thyroid conditions in pregnancy and postpartum to improve fetal and neonatal outcomes, with special reference to existing guidelines on the topic which we dissect, critique and compare with each other.  Overt hypothyroidism and hyperthyroidism should be treated appropriately in pregnancy, aiming to maintain euthyroidism. Subclinical hypothyroidism is often pragmatically treated with levothyroxine, although it has not been definitively proven whether this alters maternal or fetal outcomes. Subclinical hyperthyroidism does not usually require treatment and the possibility of non-thyroidal illness or gestational thyrotoxicosis should be considered.  Autoimmune thyroid diseases tend to improve during pregnancy but commonly flare-up or emerge in the post-partum period. Accordingly, thyroid auto-antibodies tend to decrease with pregnancy progression.  Postpartum thyroiditis should be managed based on the clinical symptoms rather than abnormal biochemical results.
DOI Link: http://dx.doi.org/10.1016/j.jcte.2016.11.001
Rights: © 2016 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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