Universal screening for thyroid disease during pregnancy should be performed

Stagnaro-Green, Alex; Dong, Allan C.; Stephenson, Mary D.

doi:10.1016/j.beem.2019.101320

Cited by 25 publications

(28 citation statements)

References 120 publications

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“…Changes in the physiological state of a pregnant woman can cause changes in thyroid function within the normal range during pregnancy (34). Such changes mainly manifest as gradual decreases in the serum levels of free T3 and free thyroxine with the increase of gestational age, while the level of TSH gradually increases (8).…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis on the influence of thyroid dysfunction in early pregnancy on pregnancy outcomes under ultrasound guidance

Geng¹,

Chen²,

et al. 2022

Ann Palliat Med

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Background: Thyroid dysfunction during pregnancy has a certain impact on pregnancy outcomes and neonatal growth, but there is no systematic evaluation of the influence of thyroid dysfunction during early pregnancy under ultrasound guidance on pregnancy outcomes.Methods: PubMed, Web of Science, Springer, and Science Direct databases were used to screen clinical studies on the effect of thyroid dysfunction during pregnancy on pregnancy outcomes from January 2010 to June 2021. Meta-analysis of data was conducted using RevMan 5.3 software. Differences of indicators were compared between the normal and abnormal thyroid function groups, including the ratio of primiparas, anemia, intrauterine growth restriction, perinatal fetal death, preterm delivery, fetal distress syndrome, cesarean section, preeclampsia, placental abruption, postpartum hemorrhage, and neonatal complications.Heterogeneity of results was assessed by chi-square test and I 2 test in RevMan5.3.Results: A total of 788,867 pregnant women were included in 13 studies. Cochrane scores were grade B or above, and Jadad scale scores were higher than 3. Anemia [odds ratio (OR) =0.

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Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis on the influence of thyroid dysfunction in early pregnancy on pregnancy outcomes under ultrasound guidance

Geng¹,

Chen²,

et al. 2022

Ann Palliat Med

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“…We used only maternal TSH and not other thyroid function/autoimmunity parameters. Although TSH is considered to be sufficient for the screening of thyroid function in pregnancy [27], the effect-if any-of pollution on any other relevant thyroid parameters was not assessed. The choice of analysing with logTSH instead of TSH values was guided by the relevant scientific literature, since thyroid hormones-the main determinants of TSH secretion-are linked to the latter mainly with log-linear relationships [28].…”

Section: Discussionmentioning

confidence: 99%

Atmospheric Pollution and Thyroid Function of Pregnant Women in Athens, Greece: A Pilot Study

Ilias¹,

Kakoulidis²,

Togias³

et al. 2020

Medical Sciences

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Exposure to air pollution and, in particular, to nitrogen dioxide (NO2) or particulate pollutants less than 2.5 μm (PM2.5) or 10 μm (PM10) in diameter has been linked to thyroid (dys)function in pregnant women. We hypothesized that there may be a dose—effect relationship between air pollutants and thyroid function parameters. We retrospectively evaluated thyrotropin (TSH) in 293 women, NO2, PM2.5 and PM10 levels in Athens. All the women were diagnosed with hypothyroidism for the first time during their pregnancy. Exposure to air pollution for each woman was considered according to her place of residence. Statistical analysis of age, pregnancy weight change, and air pollutants versus TSH was performed with ordinary least squares regression (OLS-R) and quantile regression (Q-R). A positive correlation for logTSH and PM2.5(r = +0.13, p = 0.02) was found, using OLS-R. Further analysis with Q-R showed that each incremental unit increase (for the 10th to the 90th response quantile) in PM2.5 increased logTSH(±SE) between +0.029 (0.001) to +0.025 (0.001) mIU/L (p < 0.01). The other parameters and pollutants (PM10 and NO2) had no significant effect on TSH. Our results indeed show a dose—response relationship between PM2.5 and TSH. The mechanisms involved in the pathophysiological effects of atmospheric pollutants, in particular PM2.5, are being investigated.

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“…This competition in stimulating the thyroid determines an elevation in free T4 (24,25). In addition, the circulating estrogen increases and leads to an increased thyroxine-binding globulin (TBG) which is also compensated with increased thyroid volume thereby elevating free T4 (26,27). After the first trimester hCG levels decline, the free T4 increases and TSH decreases (25,28).…”

Section: Clinical Features Of Pregnant Patients With Hyperthyroidismmentioning

confidence: 99%

“…The specific immunosuppression in pregnancy leads to decreasing levels of antibody titers with the progression of pregnancy, but after birth, the antibody titers level increases, including TRAbs. This may lead to postpartum thyroiditis and needs adequate treatment (27,31) even if Graves disease was previously treated (surgery or radioiodine ablation) (28).…”

Section: Clinical Features Of Pregnant Patients With Hyperthyroidismmentioning

confidence: 99%

Hyperthyroidism management during pregnancy and lactation (Review)

et al. 2021

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Thyroid dysfunction is a significant public health issue, affecting 5-10 more women compared to men. The estimated incidence is up to 12% and only for women the treatment rises up to 4.3 billion dollars annually. Thyroid pathology can have a major impact on female fertility and it can only be detected when preconception tests are performed. Untreated or poorly treated hyperthyroidism in a mother can affect the fetal development and pregnancy outcome. Between 0.1 and 0.4% of the pregnancies are affected by clinical hyperthyroidism. Thyroid dysfunction is associated with higher rates of pregnancy loss. Hyperthyroidism can complicate fetal health problems intrauterinely and in the neonatal period. The TSH receptor is stimulated by TSH and HCG which has a similar structure. This can lead to gestational thyrotoxicosis. Hyperthyroidism can be treated with propylthiouracil or methimazole and in selected cases, surgical treatment or radioactive iodine can be chosen. In pregnancy, the most used treatment is represented by propylthiouracil which can be used from the first trimester. The aim of this review is to assess the current data regarding the impact of thyroid dysfunction on pregnancy and to synthesize the treatment options during pregnancy and lactation.

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Universal screening for thyroid disease during pregnancy should be performed

Cited by 25 publications

References 120 publications

Systematic review and meta-analysis on the influence of thyroid dysfunction in early pregnancy on pregnancy outcomes under ultrasound guidance

Systematic review and meta-analysis on the influence of thyroid dysfunction in early pregnancy on pregnancy outcomes under ultrasound guidance

Atmospheric Pollution and Thyroid Function of Pregnant Women in Athens, Greece: A Pilot Study

Hyperthyroidism management during pregnancy and lactation (Review)

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