Controversies in thyroid disease management in pregnancy
Adequate control of thyroid function is crucial for optimal pregnancy outcomes and neurodevelopment of the offspring, and testing for thyroid function is ideally performed using manufacturer- and gestation-specific reference ranges. While universal screening for thyroid dysfunction is not recommende...
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Elsevier
2025-01-01
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Series: | Clinical Medicine |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S1470211825000053 |
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author | Pushpa Singh Kristien Boelaert |
author_facet | Pushpa Singh Kristien Boelaert |
author_sort | Pushpa Singh |
collection | DOAJ |
description | Adequate control of thyroid function is crucial for optimal pregnancy outcomes and neurodevelopment of the offspring, and testing for thyroid function is ideally performed using manufacturer- and gestation-specific reference ranges. While universal screening for thyroid dysfunction is not recommended, targeted case finding of women at risk of thyroid disease during pregnancy is advised. A number of controversies continue to fuel debate including: (i) the target range for thyroid stimulating hormone (TSH) in women with subfertility planning pregnancy, (ii) management of mild thyroid hypofunction before and during pregnancy, (iii) the treatment of thyroid peroxidase (TPO) antibody-positive euthyroid women with levothyroxine, (iv) the optimal choice of antithyroid treatment in women with hyperthyroidism. A significant body of evidence has accumulated in recent years, including large systematic reviews and meta-analyses of observational studies determining effects of thyroid dysfunction on pregnancy and fetal outcomes. In addition, outcomes from important randomised trials continue to inform current guidance on how to best care for women with thyroid dysfunction before and during pregnancy. |
format | Article |
id | doaj-art-fdcf115f11904a0e8928ad8252d9125f |
institution | Kabale University |
issn | 1470-2118 |
language | English |
publishDate | 2025-01-01 |
publisher | Elsevier |
record_format | Article |
series | Clinical Medicine |
spelling | doaj-art-fdcf115f11904a0e8928ad8252d9125f2025-02-06T05:11:16ZengElsevierClinical Medicine1470-21182025-01-01251100287Controversies in thyroid disease management in pregnancyPushpa Singh0Kristien Boelaert1University Hospital Birmingham NHS Foundation Trust, Diabetes Centre, Nuffield House, Mindelsohn Way, Edgbaston, Birmingham B15 2GW, UKDepartment of Applied Health, School of Health Sciences, Murray Learning Centre, College of Medicine and Health, University of Birmingham, Birmingham B15 2FG, UK; Corresponding author.Adequate control of thyroid function is crucial for optimal pregnancy outcomes and neurodevelopment of the offspring, and testing for thyroid function is ideally performed using manufacturer- and gestation-specific reference ranges. While universal screening for thyroid dysfunction is not recommended, targeted case finding of women at risk of thyroid disease during pregnancy is advised. A number of controversies continue to fuel debate including: (i) the target range for thyroid stimulating hormone (TSH) in women with subfertility planning pregnancy, (ii) management of mild thyroid hypofunction before and during pregnancy, (iii) the treatment of thyroid peroxidase (TPO) antibody-positive euthyroid women with levothyroxine, (iv) the optimal choice of antithyroid treatment in women with hyperthyroidism. A significant body of evidence has accumulated in recent years, including large systematic reviews and meta-analyses of observational studies determining effects of thyroid dysfunction on pregnancy and fetal outcomes. In addition, outcomes from important randomised trials continue to inform current guidance on how to best care for women with thyroid dysfunction before and during pregnancy.http://www.sciencedirect.com/science/article/pii/S1470211825000053HypothyroidismHyperthyroidismPregnancyFertilityThyroid autoimmunity |
spellingShingle | Pushpa Singh Kristien Boelaert Controversies in thyroid disease management in pregnancy Clinical Medicine Hypothyroidism Hyperthyroidism Pregnancy Fertility Thyroid autoimmunity |
title | Controversies in thyroid disease management in pregnancy |
title_full | Controversies in thyroid disease management in pregnancy |
title_fullStr | Controversies in thyroid disease management in pregnancy |
title_full_unstemmed | Controversies in thyroid disease management in pregnancy |
title_short | Controversies in thyroid disease management in pregnancy |
title_sort | controversies in thyroid disease management in pregnancy |
topic | Hypothyroidism Hyperthyroidism Pregnancy Fertility Thyroid autoimmunity |
url | http://www.sciencedirect.com/science/article/pii/S1470211825000053 |
work_keys_str_mv | AT pushpasingh controversiesinthyroiddiseasemanagementinpregnancy AT kristienboelaert controversiesinthyroiddiseasemanagementinpregnancy |