The 2017 American Thyroid Association thyroid and pregnancy guidelines provide an exhaustive review of a rapidly evolving literature and comprehensive recommendations. Although agreeing with most of the recommendations, I present an alternative perspective on the normal range of TSH in pregnancy, management of women on levothyroxine preconception and universal screening for thyroid disorders during pregnancy.
This is a preview of subscription content, access via your institution
Access options
Access Nature and 54 other Nature Portfolio journals
Get Nature+, our best-value online-access subscription
$29.99 / 30 days
cancel any time
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Pearce, E. N. Thyroid disorders during pregnancy and postpartum. Best Pract. Res. Clin. Obstet. Gynaecol. 29, 700–706 (2015).
Krassas, G. E., Poppe, E. & Glinoer, D. Thyroid function and human reproductive health. Endocr. Rev. 31, 702–755 (2012).
Alexander, E. K. et al. 2017 guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid http://dx.doi.org/10.1089/thy.2016.0457 (2017).
Qaseem, A., Snow, V., Owens, D. K. & Shekelle, P. The development of clinical practice guidelines and guidance statements of the American College of Physicians: summary of methods. Ann. Intern. Med. 153, 194–199 (2010).
Stagnaro-Green, A. et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid 21, 1081–1125 (2011).
De Groot, L. et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 97, 2543–2565 (2012).
Abalovich, M. et al. The relationship of preconception thyrotropin levels to requirements for increasing the levothyroxine dose during pregnancy in women with primary hypothyroidism. Thyroid 20, 1175–1178 (2010).
Stagnaro-Green, A. Screening pregnant women for overt thyroid disease. JAMA 313, 565–566 (2015).
Taylor, P. N. et al. TSH levels and risk of miscarriage in women on long-term levothyroxine: a community-based study. J. Clin. Endocrinol. Metab. 99, 3895–3902 (2014).
Dosiou, C. et al. Cost-effectiveness of universal and risk-based screening for autoimmune thyroid disease in pregnant women. J. Clin. Endocrinol. Metab. 97, 1536–1546 (2012).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The author declares no competing financial interests.
Rights and permissions
About this article
Cite this article
Stagnaro-Green, A. Thyroid and pregnancy — time for universal screening?. Nat Rev Endocrinol 13, 192–194 (2017). https://doi.org/10.1038/nrendo.2017.17
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrendo.2017.17