Pregnant Women on Thyroxine Substitution Are Often Dysregulated in Early Pregnancy

Hallengren, Bengt; Lantz, Mikael; Andréasson, Bengt; Grennert, Lars

doi:10.1089/thy.2008.0206

Cited by 71 publications

(78 citation statements)

References 21 publications

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“…On the other hand, around 2% of pregnant women in the DNBC had a history of thyroid disease at the time they became pregnant and another 2% developed thyroid disease in the 5-year period following the pregnancy. Women with known thyroid disease prior to a pregnancy may not be adequately treated by the time they become pregnant, and women first time diagnosed and treated for thyroid disease after a pregnancy could have suffered from undetected and untreated thyroid dysfunction during the pregnancy (35,36,37,38). Such potential thyroid abnormalities may adversely affect fetal development, particularly early brain development.…”

Section: Clinical Perspectivementioning

confidence: 99%

Maternal thyroid disease in the Danish National Birth Cohort: prevalence and risk factors

Andersen

Olsen

Laurberg

2016

European Journal of Endocrinology

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Objective: Thyroid disorders are common in women of reproductive age, but the exact burden of disease before, during and after a pregnancy is not clear. We describe the prevalence of thyroid disease in women enrolled in the Danish National Birth Cohort (DNBC) and investigate some of its risk factors. Design: Population-based study within the DNBC, which included 101 032 pregnancies (1997)(1998)(1999)(2000)(2001)(2002)(2003). Methods: We studied women enrolled in the DNBC who gave birth to a live-born child. Information on maternal thyroid disease (hyperthyroidism, hypothyroidism, benign goiter/nodules, thyroid cancer, and other) before, during and up to 5 years after the woman's first pregnancy in the cohort was obtained from self-report (telephone interview in median gestational week 17) and from nationwide registers on hospital diagnosis of thyroid disease/thyroid surgery (from 1977) and prescriptions of thyroid drugs (from 1995). Results: Of the 77 445 women studied, 3018 (3.9%) were identified with an onset of thyroid disease before (2.0%), during (0.1%) or in the 5-year period after the pregnancy (1.8%). During the pregnancy, 153 (0.2%) women received antithyroid drugs and 365 (0.5%) received thyroid hormone for hypothyroidism (83 after previous hyperthyroidism, 42 after previous surgery for benign goiter/nodules or thyroid cancer). Significant risk factors for maternal thyroid disease were age, parity, origin, iodine intake, smoking, alcohol, and BMI. Conclusions: Around 4% of Danish pregnant women had either a history of thyroid disease or thyroid disease during pregnancy or were diagnosed with thyroid disease for the first-time in the years following a pregnancy. The spectrum of thyroid disease was influenced by demographic and environmental factors.

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Section: Clinical Perspectivementioning

confidence: 99%

Maternal thyroid disease in the Danish National Birth Cohort: prevalence and risk factors

Andersen

Olsen

Laurberg

2016

European Journal of Endocrinology

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“…Therefore, evaluation of thyroid function tests during The iodine requirement during normal pregnancy: The pregnancy is great importance to prevent the above Glomerular Filtration Rate (GFR) and the subsequent abnormalities (LeBeau and Mandel, 2006;Springer et al, increase in renal blood flow, alter the normal clearance of 2009; Hallengren et al, 2009). renal iodide to be increased and this normal physiological thyroid function during pregnancy require the condition well happened during early phase of pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Thyroid Function Tests During First-trimester of Pregnancy: A Review of Literature

Mansourian¹

2010

Pakistan J. of Biological Sciences

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This literature review was conducted to summarize the main points of maternal thyroid function tests, with particular attention in the first trimester of pregnancy which accompanied with significant biochemical and metabolic alteration. The evaluation of thyroid function of either hyperthyroidism and hypothyroidism should be assessed by determination of serum Thyroid Stimulating Hormone (TSH), Thyroxine (T4), Triiodothyronine (T3), Iodine and Thyroid Autoantibodies. Glomerular filtration rate is increased during pregnancy; therefor iodine deficiency should be evaluated during the pregnancy to prevent hypothyroidism. The role which can be played by Human Chronic Gonadotropin (hCG) on stimulating the thyroid gland to become over-active was investigated. Serum level of thyroglobulin (Tg) and Thyroxin Binding Globulin (TBG) should be assessed for proper assessments of thyroid gland during pregnancy. Thyroid function tests during first-trimester of pregnancy and particularly the reference interval for thyroid function tests for pregnant women in each region has to be established, to prevent mis-diagnosis and irreversible mental and physical adverse affect for growing fetus.

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“…This was largely due to the disproportionate impact of cases where the TSH was O10 mU/l, but significantly increased already when TSH was O4.5 mU/l (52). Similarly, another small study suggested more miscarriages with both suppressed and elevated TSH in pregnant women on T 4 replacement (53).…”

Section: Evidence For Adverse Effects Of Sch During Pregnancymentioning

confidence: 98%

Management of subclinical hypothyroidism in pregnancy: are we too simplistic?

Brabant

Peeters²,

Chan

et al. 2015

European Journal of Endocrinology

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Guideline advice of many societies on the management of subclinical hypothyroidism in pregnancy suggests treatment when TSH serum levels exceed 2.5 mU/l. Justification of this procedure is based on limited experience, mainly from studies carried out in patients with positive thyroid-specific antibodies and higher TSH levels that classically define the condition in the nonpregnant state. Taking into account a lack of clear understanding of the regulation of thyroid hormone transport through the utero-placental unit and in the absence of foetal markers to monitor the adequacy of thyroxine treatment, this review attempts to discuss currently available data and suggests a more cautious approach.

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Pregnant Women on Thyroxine Substitution Are Often Dysregulated in Early Pregnancy

Cited by 71 publications

References 21 publications

Maternal thyroid disease in the Danish National Birth Cohort: prevalence and risk factors

Maternal thyroid disease in the Danish National Birth Cohort: prevalence and risk factors

Thyroid Function Tests During First-trimester of Pregnancy: A Review of Literature

Management of subclinical hypothyroidism in pregnancy: are we too simplistic?

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