Thyroid function and thyroid disorders during pregnancy: a review and care pathway.

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Maternal-Fetal Medicine

Background:

• Thyroid hormone deficiencies during pregnancy can negatively impact fetal development, particularly cognitive functions.
• Both overt and subclinical thyroid dysfunctions require appropriate management to ensure euthyroidism.

Purpose of the Study:

• To conduct a literature review on thyroid function and disorders in pregnant individuals.
• To summarize current understanding and management strategies for thyroid diseases during pregnancy.

Main Methods:

• A comprehensive literature search was performed across major databases including MEDLINE, Cochrane library, EMBASE, NLH, ClinicalTrials.gov, and Google Scholar.
• The search was limited to English-language articles published up to January 2018, focusing on thyroid diseases and pregnancy.

Main Results:

• Thyroid hormone replacement therapy (T4) aims to normalize thyrotropin (TSH) levels, with specific targets for each trimester.
• Overt hyperthyroidism necessitates prompt treatment to mitigate risks of preterm delivery, congenital malformations, and fetal demise.
• Gestational transient hyperthyroidism, often linked to hCG levels, typically does not require antithyroid medication.

Conclusions:

• Normal maternal thyroid function is vital for positive maternal and fetal outcomes during pregnancy.
• Timely and appropriate management of thyroid disorders is essential for a healthy pregnancy.