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Maternal thyroid function in pregnancy

D Glinoer1

  • 1Department of Endocrinology, Saint-Pierre Hospital, Universitè Libre de Bruxelles, Belgium.

Journal of Endocrinological Investigation
|May 1, 1993
PubMed
Summary
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Pregnancy increases thyroid hormone needs due to hormonal changes and placental activity. In iodine-deficient areas, this can cause thyroid challenges, including goiter, during pregnancy.

Area of Science:

  • Endocrinology
  • Reproductive Medicine
  • Public Health

Background:

  • Thyroid function regulation in pregnancy is complex, influenced by increased binding capacity, human chorionic gonadotropin stimulation, and placental deiodination.
  • Sufficient iodine availability is crucial for the maternal thyroid gland to adapt to pregnancy's increased demands.

Purpose of the Study:

  • To investigate the impact of iodine deficiency on thyroid function during pregnancy in an area with borderline iodine intake.
  • To assess the prevalence of excessive thyroidal stimulation and goitrogenesis in pregnant women with inadequate iodine supply.

Main Methods:

  • A randomized prospective trial was conducted on euthyroid pregnant women presenting before 16 weeks of gestation.
  • Participants met biochemical criteria for excessive thyroidal stimulation (high T3/T4 ratio, low-normal free T4 index, elevated serum thyroglobulin).

Related Experiment Videos

  • Thyroid function and volume were monitored throughout gestation.

    • Main Results:

    • Approximately one-third of pregnancies in the studied iodine-deficient area showed excessive thyroidal stimulation, characterized by relative hypothyroxinemia and elevated serum thyroglobulin.
    • Goiter developed in about 10% of women by parturition, with only partial postpartum reversibility.
    • The study highlights pregnancy as a challenge to the thyroid in iodine-insufficient conditions.

    Conclusions:

    • In iodine-deficient regions, pregnancy poses a significant challenge to maternal thyroid adaptation.
    • Inadequate iodine intake during gestation can lead to goitrogenesis and persistent thyroid volume increase.
    • Monitoring and potentially iodine supplementation are crucial for pregnant women in iodine-limited areas.