The role of levothyroxine in obstetric practice

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Perinatal Medicine

Background:

• Maternal thyroid hormones are crucial for fetal development.
• Thyroid hypofunction during pregnancy is linked to adverse obstetric and perinatal outcomes.
• Levothyroxine (LT4) is increasingly used to manage thyroid dysfunction in pregnancy.

Purpose of the Study:

• To review and compare current clinical guidelines on managing thyroid disease in pregnancy.
• To clarify the evidence on thyroid dysfunction's role in pregnancy complications.
• To assess the impact of LT4 in preventing and treating these complications.

Main Methods:

• Analysis and comparison of clinical guidelines published from 2011 onwards.
• Literature review on the effectiveness and safety of levothyroxine therapy during pregnancy.

Main Results:

• Levothyroxine (LT4) treatment is effective and safe in preventing adverse perinatal events in pregnant women with clinical hypothyroidism.
• Guidelines consistently support LT4's efficacy for overt hypothyroidism.
• LT4 is strongly recommended for overt hypothyroidism and subclinical hypothyroidism with positive thyroid autoimmunity.

Conclusions:

• Correct diagnosis and adherence to specific recommendations are essential for LT4 use in obstetrics.
• Levothyroxine therapy is a recommended intervention for specific thyroid dysfunctions during pregnancy.
• Evidence supports the effectiveness and safety of LT4 in improving perinatal outcomes.