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Roberto Negro, Thyroid Dysfunction and Pregnancy: Where Are We Five Years Later?, The Journal of Clinical Endocrinology & Metabolism, Volume 97, Issue 8, 1 August 2012, Pages 2629–2631, https://doi.org/10.1210/jc.2012-2440
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Extract
This issue of the JCEM presents new guidelines for addressing thyroid dysfunction during pregnancy and the postpartum period (1). These guidelines follow on those published 5 yr ago, highlighting the importance of this topic and reflecting the knowledge gained in the last few years. The text discusses and gives recommendations related to maternal and fetal aspects of hypothyroidism, hyperthyroidism, autoimmunity, thyroid nodules and cancer, iodine nutrition, and postpartum thyroiditis. A final paragraph is dedicated to the issue of screening for thyroid dysfunction in pregnancy.
As in the previous version, the new guidelines focus attention on either the pregnant woman or the fetus; there is no doubt that in this field, we need more randomized controlled trials (RCT) to assess the obstetrical impact of thyroid disease, but also studies that evaluate long-term outcomes such as child intelligence quotient (IQ), especially in cases of maternal subclinical hypothyroidism (2).
Of about 140 references in the new guidelines, 20% date from 2007 (the year the previous guidelines were published). What have these new references added, and what are the gray areas that require further investigation?
