Welcome to NGC. Skip directly to: Search Box, Navigation, Content.


GUIDELINE TITLE

Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline.

BIBLIOGRAPHIC SOURCE(S)

  • The Endocrine Society. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society clinical practice guideline. Chevy Chase (MD): The Endocrine Society; 2007. 79 p. [281 references]

REFERENCES SUPPORTING THE RECOMMENDATIONS

  • Abalovich M, Gutierrez S, Alcaraz G, Maccallini G, Garcia A, Levalle O. Overt and subclinical hypothyroidism complicating pregnancy. Thyroid 2002 Jan;12(1):63-8. PubMed


  • Alexander EK, Marqusee E, Lawrence J, Jarolim P, Fischer GA, Larsen PR. Timing and magnitude of increases in levothyroxine requirements during pregnancy in women with hypothyroidism. N Engl J Med 2004 Jul 15;351(3):241-9. PubMed


  • Alvarez-Marfany M, Roman SH, Drexler AJ, Robertson C, Stagnaro-Green A. Long-term prospective study of postpartum thyroid dysfunction in women with insulin dependent diabetes mellitus. J Clin Endocrinol Metab 1994 Jul;79(1):10-6. PubMed


  • Azizi F. The occurrence of permanent thyroid failure in patients with subclinical postpartum thyroiditis. Eur J Endocrinol 2005 Sep;153(3):367-71. PubMed


  • Baloch Z, Carayon P, Conte-Devolx B, Demers LM, Feldt-Rasmussen U, Henry JF, LiVosli VA, Niccoli-Sire P, John R, Ruf J, Smyth PP, Spencer CA, Stockigt JR, Guidelines Committee, National Academy of Clinical Biochemistry. Laboratory medicine practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid 2003 Jan;13(1):3-126. PubMed


  • Berg GE, Nystrom EH, Jacobsson L, Lindberg S, Lindstedt RG, Mattsson S, Niklasson CA, Noren AH, Westphal OG. Radioiodine treatment of hyperthyroidism in a pregnant women. J Nucl Med 1998 Feb;39(2):357-61. PubMed


  • Brodsky JB, Cohen EN, Brown BW Jr, Wu ML, Whitcher C. Surgery during pregnancy and fetal outcome. Am J Obstet Gynecol 1980 Dec 15;138(8):1165-7. PubMed


  • Burrow GN. The management of thyrotoxicosis in pregnancy. N Engl J Med 1985 Aug 29;313(9):562-5. [49 references] PubMed


  • Bydder SA, Clarke J, Semmens J, Joseph DJ. Genetic counselling following paternal therapeutic irradiation. Australas Radiol 2005 Apr;49(2):119-21. PubMed


  • Caixas A, Albareda M, Garcia-Patterson A, Rodriguez-Espinosa J, de Leiva A, Corcoy R. Postpartum thyroiditis in women with hypothyroidism antedating pregnancy. J Clin Endocrinol Metab 1999 Nov;84(11):4000-5. PubMed


  • Casey BM, Dashe JS, Wells CE, McIntire DD, Byrd W, Leveno KJ, Cunningham FG. Subclinical hypothyroidism and pregnancy outcomes. Obstet Gynecol 2005 Feb;105(2):239-45. PubMed


  • Casey BM, Dashe JS, Wells CE, McIntire DD, Leveno KJ, Cunningham FG. Subclinical hyperthyroidism and pregnancy outcomes. Obstet Gynecol 2006 Feb;107(2 Pt 1):337-41. PubMed


  • Chaouki ML, Benmiloud M. Prevention of iodine deficiency disorders by oral administration of lipiodol during pregnancy. Eur J Endocrinol 1994 Jun;130(6):547-51. PubMed


  • Choe W, McDougall IR. Thyroid cancer in pregnant women: diagnostic and therapeutic management. Thyroid 1994 Winter;4(4):433-5. PubMed


  • Chow SM, Yau S, Lee SH, Leung WM, Law SC. Pregnancy outcome after diagnosis of differentiated thyroid carcinoma: no deleterious effect after radioactive iodine treatment. Int J Radiat Oncol Biol Phys 2004 Jul 15;59(4):992-1000. PubMed


  • Cleare AJ, McGregor A, Chambers SM, Dawling S, O'Keane V. Thyroxine replacement increases central 5-hydroxytryptamine activity and reduces depressive symptoms in hypothyroidism. Neuroendocrinology 1996 Jul;64(1):65-9. PubMed


  • Clementi M, Di Gianantonio E, Pelo E, Mammi I, Basile RT, Tenconi R. Methimazole embryopathy: delineation of the phenotype. Am J Med Genet 1999 Mar 5;83(1):43-6. [16 references] PubMed


  • Cohen O, Pinhas-Hamiel O, Sivan E, Dolitski M, Lipitz S, Achiron R. Serial in utero ultrasonographic measurements of the fetal thyroid: a new complementary tool in the management of maternal hyperthyroidism in pregnancy. Prenat Diagn 2003 Sep;23(9):740-2. PubMed


  • Cox JL, Murray D, Chapman G. A controlled study of the onset, duration and prevalence of postnatal depression. Br J Psychiatry 1993 Jul;163:27-31. PubMed


  • Davidson KM, Richards DS, Schatz DA, Fisher DA. Successful in utero treatment of fetal goiter and hypothyroidism. N Engl J Med 1991 Feb 21;324(8):543-6. PubMed


  • Davis LE, Lucas MJ, Hankins GD, Roark ML, Cunningham FG. Thyrotoxicosis complicating pregnancy. Am J Obstet Gynecol 1989 Jan;160(1):63-70. PubMed


  • De Carolis C, Greco E, Guarino MD, Perricone C, Dal Lago A, Giacomelli R, Fontana L, Perricone R. Anti-thyroid antibodies and antiphospholipid syndrome: evidence of reduced fecundity and of poor pregnancy outcome in recurrent spontaneous aborters. Am J Reprod Immunol 2004 Oct;52(4):263-6. PubMed


  • Delange F. Optimal iodine nutrition during pregnancy, lactation and the neonatal period. Int J Endocrinol Metab 2004;2:1-12.


  • Demers LM, Spencer CA. Laboratory support for the diagnosis and monitoring of thyroid disease. National Academy of Clinical Biochemistry Laboratory Medicine practice guidelines. Washington (DC): National Academy of Clinical Biochemistry; 2002.


  • Di Gianantonio E, Schaefer C, Mastroiacovo PP, Cournot MP, Benedicenti F, Reuvers M, Occupati B, Robert E, Bellemin B, Addis A, Arnon J, Clementi M. Adverse effects of prenatal methimazole exposure. Teratology 2001 Nov;64(5):262-6. PubMed


  • Fisher DA. Fetal thyroid function: diagnosis and management of fetal thyroid disorders. Clin Obstet Gynecol 1997 Mar;40(1):16-31. [48 references] PubMed


  • Gerstein HC. Incidence of postpartum thyroid dysfunction in patients with type I diabetes mellitus. Ann Intern Med 1993 Mar 15;118(6):419-23. PubMed


  • Glinoer D, De Nayer P, Delange F, Lemone M, Toppet V, Spehl M, Grun JP, Kinthaert J, Lejeune B. A randomized trial for the treatment of mild iodine deficiency during pregnancy: maternal and neonatal effects. J Clin Endocrinol Metab 1995 Jan;80(1):258-69. PubMed


  • Glinoer D, Riahi M, Grun JP, Kinthaert J. Risk of subclinical hypothyroidism in pregnant women with asymptomatic autoimmune thyroid disorders. J Clin Endocrinol Metab 1994 Jul;79(1):197-204. PubMed


  • Glinoer D. Feto-maternal repercussions of iodine deficiency during pregnancy. An update. Ann Endocrinol (Paris) 2003 Feb;64(1):37-44. [27 references] PubMed


  • Glinoer D. Pregnancy and iodine. Thyroid 2001 May;11(5):471-81. [38 references] PubMed


  • Glinoer D. The regulation of thyroid function in pregnancy: pathways of endocrine adaptation from physiology to pathology. Endocr Rev 1997 Jun;18(3):404-33. [276 references] PubMed


  • Goodwin TM, Montoro M, Mestman JH, Pekary AE, Hershman JM. The role of chorionic gonadotropin in transient hyperthyroidism of hyperemesis gravidarum. J Clin Endocrinol Metab 1992 Nov;75(5):1333-7. PubMed


  • Goodwin TM, Montoro M, Mestman JH. Transient hyperthyroidism and hyperemesis gravidarum: clinical aspects. Am J Obstet Gynecol 1992 Sep;167(3):648-52. PubMed


  • Gorman CA. Radioiodine and pregnancy. Thyroid 1999 Jul;9(7):721-6. [45 references] PubMed


  • Greenberg F. Choanal atresia and athelia: methimazole teratogenicity or a new syndrome. Am J Med Genet 1987 Dec;28(4):931-4. PubMed


  • Haddow JE, Palomaki GE, Allan WC, Williams JR, Knight GJ, Gagnon J, O'Heir CE, Mitchell ML, Hermos RJ, Waisbren SE, Faix JD, Klein RZ. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med 1999 Aug 19;341(8):549-55. PubMed


  • Harris B, Othman S, Davies JA, Weppner GJ, Richards CJ, Newcombe RG, Lazarus JH, Parkes AB, Hall R, Phillips DI. Association between postpartum thyroid dysfunction and thyroid antibodies and depression. BMJ 1992 Jul 18;305(6846):152-6. PubMed


  • Herzon FS, Morris DM, Segal MN, Rauch G, Parnell T. Coexistent thyroid cancer and pregnancy. Arch Otolaryngol Head Neck Surg 1994 Nov;120(11):1191-3. PubMed


  • Hollowell JG, Staehling NW, Hannon WH, Flanders DW, Gunter EW, Maberly GF, Braverman LE, Pino S, Miller DT, Garbe PL, DeLozier DM, Jackson RJ. Iodine nutrition in the United States. Trends and public health implications: iodine excretion data from National Health and Nutrition Examination Surveys I and III (1971-1974 and 1988-1994). J Clin Endocrinol Metab 1998 Oct;83(10):3401-8. PubMed


  • Johnsson E, Larsson G, Ljunggren M. Severe malformations in infant born to hyperthyroid woman on methimazole. Lancet 1997 Nov 22;350(9090):1520. PubMed


  • Kaplan MM. Monitoring thyroxine treatment during pregnancy. Thyroid 1992 Summer;2(2):147-52. PubMed


  • Klein RZ, Haddow JE, Faix JD, Brown RS, Hermos RJ, Pulkkinen A, Mitchell ML. Prevalence of thyroid deficiency in pregnant women. Clin Endocrinol (Oxf) 1991 Jul;35(1):41-6. PubMed


  • Kuijpens JL, De Hann-Meulman M, Vader HL, Pop VJ, Wiersinga WM, Drexhage HA. Cell-mediated immunity and postpartum thyroid dysfunction: a possibility for the prediction of disease. J Clin Endocrinol Metab 1998 Jun;83(6):1959-66. PubMed


  • Kung AW, Chau MT, Lao TT, Tam SC, Low LC. The effect of pregnancy on thyroid nodule formation. J Clin Endocrinol Metab 2002 Mar;87(3):1010-4. PubMed


  • Laurberg P, Nygaard B, Glinoer D, Grussendorf M, Orgiazzi J. Guidelines for TSH-receptor antibody measurements in pregnancy: results of an evidence-based symposium organized by the European Thyroid Association. Eur J Endocrinol 1998 Dec;139(6):584-6. PubMed


  • Lazarus JH. Thyroid disorders associated with pregnancy: etiology, diagnosis, and management. Treat Endocrinol 2005;4(1):31-41. [55 references] PubMed


  • Leung AS, Millar LK, Koonings PP, Montoro M, Mestman JH. Perinatal outcome in hypothyroid pregnancies. Obstet Gynecol 1993 Mar;81(3):349-53. PubMed


  • Liesenkotter KP, Gopel W, Bogner U, Stach B, Gruters A. Earliest prevention of endemic goiter by iodine supplementation during pregnancy. Eur J Endocrinol 1996 Apr;134(4):443-8. PubMed


  • Lowe SA. Diagnostic radiography in pregnancy: risks and reality. Aust N Z J Obstet Gynaecol 2004 Jun;44(3):191-6. [33 references] PubMed


  • Lucas A, Pizarro E, Granada ML, Salinas I, Foz M, Sanmarti A. Postpartum thyroiditis: epidemiology and clinical evolution in a nonselected population. Thyroid 2000 Jan;10(1):71-7. PubMed


  • Luton D, Le Gac I, Vuillard E, Castanet M, Guibourdenche J, Noel M, Toubert ME, Leger J, Boissinot C, Schlageter MH, Garel C, Tebeka B, Oury JF, Czernichow P, Polak M. Management of Graves' disease during pregnancy: the key role of fetal thyroid gland monitoring. J Clin Endocrinol Metab 2005 Nov;90(11):6093-8. PubMed


  • Mandel SJ, Brent GA, Larsen PR. Review of antithyroid drug use during pregnancy and report of a case of aplasia cutis. Thyroid 1994 Spring;4(1):129-33. [43 references] PubMed


  • Mandel SJ, Larsen PR, Seely EW, Brent GA. Increased need for thyroxine during pregnancy in women with primary hypothyroidism. N Engl J Med 1990 Jul 12;323(2):91-6. PubMed


  • Martinez-Frias ML, Cereijo A, Rodriguez-Pinilla E, Urioste M. Methimazole in animal feed and congenital aplasia cutis. Lancet 1992 Mar 21;339(8795):742-3. PubMed


  • Mazzaferri EL, Jhiang SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer [published erratum appears in Am J Med 1995 Feb;98(2):215]. Am J Med 1994 Nov;97(5):418-28. PubMed


  • McCanlies E, O'Leary LA, Foley TP, Kramer MK, Burke JP, Libman A, Swan JS, Steenkiste AR, Mccarthy BJ, Trucco M, Dorman JS. Hashimoto's thyroiditis and insulin-dependent diabetes mellitus: differences among individuals with and without abnormal thyroid function. J Clin Endocrinol Metab 1998 May;83(5):1548-51. PubMed


  • McKenzie JM, Zakarija M. Fetal and neonatal hyperthyroidism and hypothyroidism due to maternal TSH receptor antibodies. Thyroid 1992 Summer;2(2):155-9. [30 references] PubMed


  • Mestman JH. Hyperthyroidism in pregnancy. Baillieres Best Pract Res Clin Endocrinol Metab 2004 Jun;18(2):267-88. [88 references] PubMed


  • Millar LK, Wing DA, Leung AS, Koonings PP, Montoro MN, Mestman JH. Low birth weight and preeclampsia in pregnancies complicated by hyperthyroidism. Obstet Gynecol 1994 Dec;84(6):946-9. PubMed


  • Mitsuda N, Tamaki H, Amino N, Hosono T, Miyai K, Tanizawa O. Risk factors for developmental disorders in infants born to women with Graves disease. Obstet Gynecol 1992 Sep;80(3 Pt 1):359-64. PubMed


  • Momotani N, Noh J, Oyanagi H, Ishikawa N, Ito K. Antithyroid drug therapy for Graves' disease during pregnancy. Optimal regimen for fetal thyroid status. N Engl J Med 1986 Jul 3;315(1):24-8. PubMed


  • Moosa M, Mazzaferri EL. Outcome of differentiated thyroid cancer diagnosed in pregnant women. J Clin Endocrinol Metab 1997 Sep;82(9):2862-6. PubMed


  • Mortimer RH, Tyack SA, Galligan JP, Perry-Keene DA, Tan YM. Graves' disease in pregnancy: TSH receptor binding inhibiting immunoglobulins and maternal and neonatal thyroid function. Clin Endocrinol (Oxf) 1990 Feb;32(2):141-52. PubMed


  • Muller AF, Drexhage HA, Berghout A. Postpartum thyroiditis and autoimmune thyroiditis in women of childbearing age: recent insights and consequences for antenatal and postnatal care. Endocr Rev 2001 Oct;22(5):605-30. [275 references] PubMed


  • Nachum Z, Rakover Y, Weiner E, Shalev E. Graves' disease in pregnancy: prospective evaluation of a selective invasive treatment protocol. Am J Obstet Gynecol 2003 Jul;189(1):159-65. PubMed


  • Nohr SB, Laurberg P. Opposite variations in maternal and neonatal thyroid function induced by iodine supplementation during pregnancy. J Clin Endocrinol Metab 2000 Feb;85(2):623-7. PubMed


  • Othman S, Phillips DI, Parkes AB, Richards CJ, Harris B, Fung H, Darke C, John R, Hall R, Lazarus JH. A long-term follow-up of postpartum thyroiditis. Clin Endocrinol (Oxf) 1990 May;32(5):559-64. PubMed


  • Panesar NS, Li CY, Rogers MS. Reference intervals for thyroid hormones in pregnant Chinese women. Ann Clin Biochem 2001 Jul;38(Pt 4):329-32. PubMed


  • Peleg D, Cada S, Peleg A, Ben-Ami M. The relationship between maternal serum thyroid-stimulating immunoglobulin and fetal and neonatal thyrotoxicosis. Obstet Gynecol 2002 Jun;99(6):1040-3. PubMed


  • Polak M, Le Gac I, Vuillard E, Guibourdenche J, Leger J, Toubert ME, Madec AM, Oury JF, Czernichow P, Luton D. Fetal and neonatal thyroid function in relation to maternal Graves' disease. Baillieres Best Pract Res Clin Endocrinol Metab 2004 Jun;18(2):289-302. [47 references] PubMed


  • Polak M, Leger J, Luton D, Oury JF, Vuillard E, Boissinot C, Czernichow P. Fetal cord blood sampling in the diagnosis and the treatment of fetal hyperthyroidism in the offsprings of a euthyroid mother, producing thyroid stimulating immunoglobulins. Ann Endocrinol (Paris) 1997;58(4):338-42. PubMed


  • Pop VJ, de Rooy HA, Vader HL, van der Heide D, van Son MM, Komproe IH. Microsomal antibodies during gestation in relation to postpartum thyroid dysfunction and depression. Acta Endocrinol (Copenh) 1993 Jul;129(1):26-30. PubMed


  • Porreco RP, Bloch CA. Fetal blood sampling in the management of intrauterine thyrotoxicosis. Obstet Gynecol 1990 Sep;76(3 Pt 2):509-12. PubMed


  • Premawardhana LD, Parkes AB, Ammari F, John R, Darke C, Adams H, Lazarus JH. Postpartum thyroiditis and long-term thyroid status: prognostic influence of thyroid peroxidase antibodies and ultrasound echogenicity. J Clin Endocrinol Metab 2000 Jan;85(1):71-5. PubMed


  • Premawardhana LD, Parkes AB, John R, Harris B, Lazarus JH. Thyroid peroxidase antibodies in early pregnancy: utility for prediction of postpartum thyroid dysfunction and implications for screening. Thyroid 2004 Aug;14(8):610-5. PubMed


  • Romano R, Jannini EA, Pepe M, Grimaldi A, Olivieri M, Spennati P, Cappa F, D'Armiento M. The effects of iodoprophylaxis on thyroid size during pregnancy. Am J Obstet Gynecol 1991 Feb;164(2):482-5. PubMed


  • Rosen IB, Korman M, Walfish PG. Thyroid nodular disease in pregnancy: current diagnosis and management. Clin Obstet Gynecol 1997 Mar;40(1):81-9. [23 references] PubMed


  • Sapin R, D'Herbomez M, Schlienger JL. Free thyroxine measured with equilibrium dialysis and nine immunoassays decreases in late pregnancy. Clin Lab 2004;50(9-10):581-4. PubMed


  • Schlumberger M, De Vathaire F, Ceccarelli C, Francese C, Pinchera A, Parmentier C. Outcome of pregnancy in women with thyroid carcinoma. J Endocrinol Invest 1995 Feb;18(2):150-1. PubMed


  • Sher G, Maassarani G, Zouves C, Feinman M, Sohn S, Matzner W, Chong P, Ching W. The use of combined heparin/aspirin and immunoglobulin G therapy in the treatment of in vitro fertilization patients with antithyroid antibodies. Am J Reprod Immunol 1998 Apr;39(4):223-5. PubMed


  • Soldin OP, Tractenberg RE, Hollowell JG, Jonklaas J, Janicic N, Soldin SJ. Trimester-specific changes in maternal thyroid hormone, thyrotropin, and thyroglobulin concentrations during gestation: trends and associations across trimesters in iodine sufficiency. Thyroid 2004 Dec;14(12):1084-90. PubMed


  • Stagnaro-Green A, Roman SH, Cobin RH, el-Harazy E, Alvarez-Marfany M, Davies TF. Detection of at-risk pregnancy by means of highly sensitive assays for thyroid autoantibodies. JAMA 1990 Sep 19;264(11):1422-5. PubMed


  • Stagnaro-Green A. Clinical review 152: Postpartum thyroiditis. J Clin Endocrinol Metab 2002 Sep;87(9):4042-7. [45 references] PubMed


  • Stamp GE, Crowther CA. Postnatal depression: a South Australian prospective survey. Aust N Z J Obstet Gynaecol 1994 May;34(2):164-7. PubMed


  • Stice RC, Grant CS, Gharib H, van Heerden JA. The management of Graves' disease during pregnancy. Surg Gynecol Obstet 1984 Feb;158(2):157-60. PubMed


  • Tachi J, Amino N, Tamaki H, Aozasa M, Iwatani Y, Miyai K. Long term follow-up and HLA association in patients with postpartum hypothyroidism. J Clin Endocrinol Metab 1988 Mar;66(3):480-4. PubMed


  • Tan JY, Loh KC, Yeo GS, Chee YC. Transient hyperthyroidism of hyperemesis gravidarum. BJOG 2002 Jun;109(6):683-8. PubMed


  • Van Kamp IL, Klumper FJ, Oepkes D, Meerman RH, Scherjon SA, Vandenbussche FP, Kanhai HH. Complications of intrauterine intravascular transfusion for fetal anemia due to maternal red-cell alloimmunization. Am J Obstet Gynecol 2005 Jan;192(1):171-7. PubMed


  • Vini L, Hyer S, Pratt B, Harmer C. Management of differentiated thyroid cancer diagnosed during pregnancy. Eur J Endocrinol 1999 May;140(5):404-6. PubMed


  • Wallace C, Couch R, Ginsberg J. Fetal thyrotoxicosis: a case report and recommendations for prediction, diagnosis, and treatment. Thyroid 1995 Apr;5(2):125-8. PubMed


  • Wenstrom KD, Weiner CP, Williamson RA, Grant SS. Prenatal diagnosis of fetal hyperthyroidism using funipuncture. Obstet Gynecol 1990 Sep;76(3 Pt 2):513-7. PubMed


  • Wilson LC, Kerr BA, Wilkinson R, Fossard C, Donnai D. Choanal atresia and hypothelia following methimazole exposure in utero: a second report. Am J Med Genet 1998 Jan 13;75(2):220-2. PubMed


  • World Health Organization (WHO). The prevention and control of iodine deficiency in pregnant and lactating women and in children under 2 years: recommendations of a WHO technical consultation. Public Health Nutr 2005 Jan;(in press)


  • Zanzonico PB. Radiation dose to patients and relatives incident to 131I therapy. Thyroid 1997 Apr;7(2):199-204. [20 references] PubMed


© 1998-2009 National Guideline Clearinghouse

Date Modified: 2/9/2009

 

 

   
DHHS Logo