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Thyroid dysfunction and pregnancy outcomes.

Sima Nazarpour1, Fahimeh Ramezani Tehrani2, Masoumeh Simbar1

  • 1Department of Reproductive Health, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Iranian Journal of Reproductive Medicine
|October 24, 2015
PubMed
Summary

Thyroid dysfunction during pregnancy, including overt hyperthyroidism and hypothyroidism, significantly impacts pregnancy outcomes. More research is needed to clarify the effects of subclinical thyroid issues and thyroid autoimmunity on maternal and infant health.

Keywords:
HyperthyroidismHypothyroidismPregnancy outcomeThyroid disease

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Area of Science:

  • Obstetrics and Gynecology
  • Endocrinology
  • Reproductive Health

Background:

  • Pregnancy significantly alters thyroid function in both healthy and pre-existing thyroid conditions.
  • Thyroid dysfunction prevalence is notably high among pregnant populations.

Purpose of the Study:

  • To review and raise awareness of the adverse effects of thyroid dysfunction on pregnancy outcomes.
  • To examine hyperthyroidism, hypothyroidism, and thyroid autoimmune positivity in pregnant women.

Main Methods:

  • A comprehensive literature search was conducted across Medline, Embase, and Cochrane Library.
  • Included studies comprised randomized clinical trials, cohort studies, case-control studies, and case reports.
  • Excluded were studies on non-pregnant women or those lacking adequate quality.

Main Results:

  • Overt hyperthyroidism and hypothyroidism are linked to numerous adverse pregnancy outcomes, including miscarriage, preterm delivery, preeclampsia, and fetal developmental issues.
  • Overt hypothyroidism is associated with abortion, anemia, hypertension, placental abruption, postpartum hemorrhage, and neonatal respiratory distress.
  • The impact of subclinical hypothyroidism and thyroid antibody positivity remains unclear, with conflicting evidence regarding placental abruption, preterm birth, and gestational hypertension.

Conclusions:

  • The adverse effects of overt thyroid dysfunction on maternal and fetal health are well-established.
  • Evidence regarding the complications of subclinical thyroid dysfunction and thyroid autoimmunity during pregnancy is controversial.
  • Further research is required to elucidate the maternal and neonatal outcomes associated with subclinical thyroid dysfunction in pregnancy.