Postpartum thyroiditis: an autoimmune thyroid disorder which predicts future thyroid health

Abstract

Summary: Postpartum thyroiditis is a potentially destructive lymphocytic thyroiditis occurring in approximately 8% of the pregnant population, making it the most common endocrine disorder associated with pregnancy. This autoimmune thyroid disorder is precipitated by the postpartum immunological rebound that follows the partial immunosuppression of pregnancy, in individuals already at risk of autoimmune thyroid disease. The manifestations of postpartum thyroiditis are usually not present at the six-week postpartum visit and thus it is important that all physicians be aware of the risks, presentation and intervention required for this common disorder. Postpartum thyroiditis is a strong predictor of future thyroid health and it is essential that women with a history of postpartum thyroiditis be screened regularly, especially prior to a future pregnancy. Selenium supplementation has recently been identified as a potential means to prevent postpartum thyroiditis in women at risk but further studies are required before recommendations for its use can be made.

Maternal Thyroid Hormone Replacement Therapy Exposure and Language and Communication Skills of Offspring at 8 Years of Age

“…Yet, if it holds true, it is likely that women who initiate THRT after delivery might have had thyroid antibodies already present during pregnancy. 39 The presence of thyroid antibodies has been previously associated with impaired child development. 40 In this study, we found no evidence for an association between THRT initiation after delivery and child language and communication skill deficits.…”

Thyroid hormone replacement therapy patterns in pregnant women and perinatal outcomes in the offspring

“…The THRT after delivery group (n = 1397) included women that received THRT prescriptions within 1 year after delivery and served as a proxy for a disease‐comparator group. This group is important to study, as women might develop postpartum hypothyroidism because of postpartum thyroiditis . Hence, these women might have thyroid antibodies present during pregnancy, which has previously been connected to adverse immediate pregnancy outcomes …”

Postpartum thyroiditis

“…In a study of 26 women with confirmed PPT, only two would have returned to their healthcare provider based on their perceptions of the severity of their symptoms 13. Symptoms may not occur until after the six week postpartum visit that is standard in many countries,14 thus requiring the affected postpartum woman to request or initiate a visit for recognised symptoms. Testing for PPT is another reason why this condition might be missed.…”