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Subclinical hypothyroidism in pregnancy.
Freddy J K Toloza1,2, Sanaz Abedzadeh-Anaraki1, Spyridoula Maraka1,2,3
1Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Current Opinion in Endocrinology, Diabetes, and Obesity
|July 30, 2019
Summary
Subclinical hypothyroidism (SCH) in pregnancy is linked to adverse maternofetal and offspring outcomes, particularly in women with thyroid peroxidase antibodies. Levothyroxine treatment benefits some outcomes but not offspring neurodevelopment.
Area of Science:
- Reproductive endocrinology
- Maternal-fetal medicine
- Thyroidology
Background:
- Subclinical hypothyroidism (SCH) is prevalent in women of reproductive age.
- Adequate maternal thyroid hormone levels are crucial during pregnancy.
- The impact of SCH and its treatment on pregnancy outcomes requires clarification.
Purpose of the Study:
- To review recent evidence on subclinical hypothyroidism during pregnancy.
- To examine the efficacy of SCH treatment on maternofetal and offspring outcomes.
- To discuss how current evidence informs clinical care for pregnant women with SCH.
Main Methods:
- Review of recent observational and interventional studies.
- Analysis of associations between SCH and maternofetal/offspring outcomes.
- Evaluation of levothyroxine (LT4) treatment effects.
Main Results:
- SCH is associated with adverse maternal, neonatal, and offspring outcomes, especially in thyroid peroxidase autoantibody-positive women.
- Levothyroxine (LT4) treatment demonstrated benefits for specific pregnancy outcomes.
- No significant effect of LT4 treatment was observed on offspring neurodevelopment.
Conclusions:
- Evidence reinforces the link between SCH and adverse maternofetal/offspring outcomes.
- Individualized diagnostic assessment considering risk factors may improve SCH management.
- The long-term effectiveness of LT4 treatment on maternofetal and offspring outcomes remains under investigation.
