Overview of Hypothyroidism in Pregnancy

Kroopnick, Jeffrey M.; Kim, Caroline S.

doi:10.1055/s-0036-1593488

Cited by 11 publications

(6 citation statements)

References 52 publications

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“…Thyroid diseases including SCH are known to be more prevalent in women than in men ( 9 , 10 ). Approximately 5–15% of women are positive for thyroid autoantibodies, either anti-thyroid peroxidase antibody (TPOAb) or anti-thyroglobulin antibody ( 11 , 12 ). The higher incidence of thyroid autoantibodies in women is reported to account for their higher incidence of thyroid disease ( 9 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

Sex differences in risk factors for subclinical hypothyroidism

Ha¹,

Lee²,

Jo³

et al. 2018

Endocrine Connections

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ObjectiveTo investigate the prevalence of subclinical hypothyroidism (SCH) in Korean adults and identify the risk factors for the occurrence of SCH by sex.Design and methodsThis study used data from the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI), a cross-sectional, nationally representative survey, which comprises a health interview survey, a health examination survey and a nutrition survey. To examine SCH, the reference range of thyroid-stimulating hormone (TSH) was defined using both the range provided by the test kit manufacturer (SCH-M) and a population-based range (SCH-P). We investigated the prevalence of SCH and its risk factors by sex using both reference ranges.ResultsThe prevalence of SCH in Koreans according to SCH-M (0.35–5.5 µIU/mL) was 5.6%, and 3.3% with SCH-P (0.62–6.68 µIU/mL). For men, smoking significantly reduced the incidence of SCH, positive anti-thyroid peroxidase antibody (TPOAb) significantly increased the risk of SCH, and in an adjusted model, the risk of SCH in all quartiles increased as the urine iodine creatinine ratio (UICR) quartile increased. For women, positive TPOAb was confirmed as a risk factor for SCH, as was the highest UICR quartile. Furthermore, the odds ratio for SCH in urban vs rural residence was 1.78.ConclusionsThe prevalence rates of SCH were similar to those reported in the literature and previously known risk factors were confirmed using both TSH reference ranges. The notable findings from this study are that the increased risk of SCH with increased iodine intake was more marked in men than in women and that residential area may be a risk factor for SCH in women.

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Section: Introductionmentioning

confidence: 99%

Sex differences in risk factors for subclinical hypothyroidism

Ha¹,

Lee²,

Jo³

et al. 2018

Endocrine Connections

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“…6 Cignini P et al found that hypothyroidism occurs in 2.5% of pregnancies; however, the frequency of OH is estimated to be between 0.2 and 1.0%. 7 They found that prevalence of SH varies between 1.5 and 4.0%. 9 In present study, total prevalence of hyperthyroidism was 9.5%%.…”

Section: Discussionmentioning

confidence: 99%

“…Subclinical hypothyroidism is typically defined as an elevated TSH and normal FT4 levels. 7 Treatment is necessary when TSH is 10 or more, regardless of the T4 level. In addition, TSH should be monitored every 4 weeks during the first 20 weeks of gestation, then once again between 26 and 32 weeks.…”

mentioning

confidence: 99%

Thyroid screening in pregnancy

Wagh

Mundra²,

Upadhye³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Thyroid hormone is critical to normal development of the baby’s brain and nervous system. During the first trimester, the fetus depends on the mother’s supply of thyroid hormone, which comes through the placenta. At around 12 weeks, the baby’s thyroid begins to function on its own. In our study, complete thyroid profile of all antenatal patients was done at the first antenatal visit along with routine investigations. Aim of the study was to study the prevalence of hypothyroidism and hyperthyroidism in low income, urban pregnant women.Methods: This is a retrospective study that includes 400 pregnant women attending the antenatal clinic at Government medical college and hospital, Nagpur in the month of April 2017. These patient’s data was randomly selected in the biochemistry department where samples come. Thyroid profile is being done as a routine test along with other antenatal profile tests in our hospital. Thyroid profile test includes serum T3, serum T4 and serum TSH.Results: A total of 400 pregnant women were included in this study. Results showed 34% prevalence of hypothyroidism of which 30% being subclinical hypothyroidism and 4% overt hypothyroidism. There was 9.5% prevalence of hyperthyroidism of which 5.5% being subclinical hyperthyroidism and 4% overt hyperthyroidism.Conclusions: The study shows a very high prevalence rate of hypothyroidism in the patients attending the antenatal outpatient department at Government medical college and hospital, Nagpur. This justifies the inclusion of thyroid profile test as a routine test in the antenatal profile.

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“…The exact pathophysiology for these adverse effects is not known but it has been speculated that presence of anti-thyroid antibodies is part of a generalized autoimmune imbalance that may be responsible for increased complications [10]. Women who are positive for thyroid antibodies before pregnancy may develop subclinical hypothyroidism, possibly due to latent thyroid dysfunction which becomes overt due to the increasing demands during pregnancy [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Association of thyroid antibodies status on the outcomes of pregnant women with hypothyroidism (maternal hypothyroidism on pregnancy outcomes, MHPO-4)

Kiran

Sheikh

Islam

2021

BMC Pregnancy Childbirth

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Background Autoimmunity increases with age and is often commonly evaluated in women of the reproductive age group. Prevalence of thyroid antibodies is common even in euthyroid pregnant women. We aim to compare the association of thyroid antibody status on the maternal and neonatal outcomes in pregnant women with hypothyroidism. Methods We conducted a cross-sectional retrospective study on 718 cases in the Aga Khan University Hospital. Information was collected on pregnant women who have been diagnosed with hypothyroidism before conception or during their antenatal period. Laboratory data were recorded for thyroid peroxidase antibodies, anti-thyroglobulin antibodies, and thyroid-stimulating hormone levels. Maternal and neonatal outcomes were also noted from medical file records. Data analysis was performed on Statistical Package for the Social Sciences version 20.0. Results Overall, 146 out 718 cases were included for final analysis. Thyroid peroxidase antibodies were positive in 66.4% and anti-thyroglobulin was positive in 52.1% cases, whereas 43.8% of cases had both antibodies positive. Pre-gestational diabetes was significantly associated with thyroid autoimmunity. There was a 73% less chance of gestational hypertension for thyroid autoimmune groups. Gestational diabetes and maternal (chronic) hypertension were found to have an independent effect on postpartum hemorrhage. Hypertensive disorders in pregnancy were found to have an independent risk for premature birth. Conclusion Our study reports a 74.7% prevalence of positive thyroid antibodies in hypothyroid pregnant women, with higher association with pre-gestational diabetes. Gestational hypertension was least likely to occur in thyroid autoimmune groups. None of the outcomes were independently associated with worse outcomes.

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Overview of Hypothyroidism in Pregnancy

Cited by 11 publications

References 52 publications

Sex differences in risk factors for subclinical hypothyroidism

Sex differences in risk factors for subclinical hypothyroidism

Thyroid screening in pregnancy

Association of thyroid antibodies status on the outcomes of pregnant women with hypothyroidism (maternal hypothyroidism on pregnancy outcomes, MHPO-4)

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