Thyroid (dys-)function in normal and disturbed pregnancy

Area of Science:

• Endocrinology
• Reproductive Medicine
• Maternal-Fetal Medicine

Background:

• Physiological changes in maternal thyroid function occur during pregnancy, influenced by hormonal and metabolic shifts.
• Human chorionic gonadotropin stimulates maternal thyroid hormone production, crucial for early fetal development.
• Adequate maternal thyroid hormones are vital, particularly in the first trimester before the fetal thyroid is functional.

Purpose of the Study:

• To summarize current knowledge on thyroid dysfunction during pregnancy, including autoimmunity, hypothyroidism, and hyperthyroidism.
• To analyze the impact of thyroid dysfunction on miscarriage and other pregnancy disorders.
• To review current guidelines on thyroid function in pregnancy.

Main Methods:

• Conducted a Medline literature search.
• Analyzed current clinical guidelines regarding thyroid function and pregnancy.
• Included studies on TSH levels, thyroid autoantibodies, and hypothyroidism in relation to pregnancy outcomes.

Main Results:

• Thyroid dysfunction is associated with adverse pregnancy outcomes.
• Thyroid autoantibodies correlate with an increased risk of miscarriage.
• (Subclinical) hypothyroidism affects both infertile and fertile women.

Conclusions:

• Maternal thyroid dysfunction adversely affects pregnancy.
• Routine iodine supplementation and treatment of thyroid disorders are important.
• Measuring and adjusting TSH levels to <2.5 mIU/l in women of childbearing age is recommended for optimal maternal and fetal health.