The regular use of iodine-containing supplements proved effective in reducing the risk of inappropriately low FT4 levels during pregnancy. The observed TSH increase in 150-I women may be because of a transient stunning effect on the thyroid gland, occurring as a result of the abrupt increase in daily iodine intake. Whilst the importance of gestational iodine supplementation is undisputed, we believe that in mild-moderately ID areas, women considering conception should be advised to take iodine supplementation for several months prior to pregnancy.
Both thyroid diseases SH and autoimmune disorder are independently associated with very early embryo loss, but women suffering from SH have a lower gestational age at abortion.
Objective: To longitudinally evaluate the timing of maternal thyroid underfunction occurrence in mildly iodine-deficient (ID) pregnant women, and ultimately assess the benefit of thyroid function testing at early gestation only in identifying maternal thyroid underfunction. Participants/methods: Serum free-thyroxine and TSH were measured in 220 consecutive women once in early pregnancy (by week 12) and twice per trimester subsequently. Anti-thyroperoxidase and antithyroglobulin were also determined at initial and final observation. Results: Thyroid autoantibodies were detectable in 8.2% women. Overall, the prevalence of hypothyroidism over the course of gestation was 11.8% (26/220), with a relative risk of hypothyroidism in antibody-positive women of 5.0 (c 2 20.02, P!0.0005). Nonetheless, almost 70% hypothyroid women tested negative for thyroid autoantibodies. Fifteen/26 (57.7%) hypothyroid women were identified at presentation, and the remaining 11 at either early (6/11) or late (5/11) phases of the 2nd trimester. Isolated hypothyroxinemia was observed in 56/220 (25.4%) women, mostly from the 2nd trimester onwards. Conclusions: In mildly ID areas thyroid function testing early in gestation seems to be only partly effective in identifying thyroid underfunction in pregnant women. Indeed, in our series more than 40% hypothyroid women would not have been diagnosed had we limited our observation to early thyroid function tests alone. Although thyroid autoimmunity carried a 5-fold increased risk of hypothyroidism, iodine deficiency seems to be a major determinant in the occurrence of thyroid underfunction. Adequate iodine supplementation should be strongly recommended to meet the increased hormone demand over gestation.
All kinds of anaesthesia seem to be safe, but loco-regional blockade shows more advantages on the neonatal outcome also when a conversion is necessary.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.