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The effects of maternal thyroid hormone function on early pregnancy

Bernardi, Lia A.; Scoccia, Bert

Current Opinion in Obstetrics and Gynecology: August 2013 - Volume 25 - Issue 4 - p 267–273
doi: 10.1097/GCO.0b013e3283630d80
REPRODUCTIVE ENDOCRINOLOGY: Edited by David L. Olive

Purpose of review It is unclear whether pregnancy outcomes are impacted by nonovert thyroid disease, and whether detection and treatment of abnormalities improve outcomes. Consequently, there is an ongoing debate regarding universal thyroid screening in pregnancy. A lack of solid evidence has prompted researchers to evaluate the role of screening and to examine pregnancy outcomes in women with thyroid dysfunction. In addition, as IVF has developed into a commonly used procedure, its impact on thyroid function has also been investigated. The most current literature on these topics will be summarized in this review.

Recent findings The multiple societies that have published guidelines on thyroid disease in pregnancy have developed different recommendations, with none definitively advocating for universal screening at this time. However, recent studies examining the role of screening have supported it from an economic and prevalence standpoint. Despite this, evidence has failed to consistently demonstrate that treatment of nonovert thyroid disorders improves maternal and fetal outcomes. Recent research does suggest that close monitoring for and treatment of thyroid dysfunction is warranted in women undergoing IVF.

Summary Further research must be performed to determine whether treatment of nonovert thyroid disease during pregnancy impacts outcomes. Concrete evidence will likely influence the universal screening debate.

Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois, USA

Correspondence to Bert Scoccia, MD, University of Illinois at Chicago, 820 S. Wood Street, MC 808, Chicago, IL 60612, USA. Tel: +1 312 996 0678; e-mail: bscocc@uic.edu

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins