Hypothyroidism and isolated hypothyroxinemia in pregnancy, from physiology to the clinic
Many changes occur in the physiology of the maternal thyroid gland to maintain an adequate level of thyroid hormones (THs) at each stage of gestation during normal pregnancy, however, some factors can produce low levels of these hormones, which can alter the onset and progression of pregnancy. Defic...
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doaj-0af01fc17e57497c8bf002e6a9ce3ca02020-11-25T02:22:03ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592019-11-01586757763Hypothyroidism and isolated hypothyroxinemia in pregnancy, from physiology to the clinicEunice López-Muñoz0Leovigildo Mateos-Sánchez1Gabriel Enrique Mejía-Terrazas2Sharon Esperanza Bedwell-Cordero3Unidad de Investigación Médica en Medicina Reproductiva, Unidad Médica de Alta Especialidad, Hospital de Gineco Obstetricia No. 4, Luis Castelazo Ayala, Instituto Mexicano del Seguro Social, Río Magdalena 289, 6° Piso, Laboratorio K, Colonia Tizapan San Ángel, Alcaldía Álvaro Obregón, C.P. 01090, Ciudad de México, Mexico; Corresponding author.Unidad de Cuidados Intensivos Neonatales, UMAE Hospital de Gineco Obstetricia No. 4, Luis Castelazo Ayala, Instituto Mexicano del Seguro Social, Río Magdalena 289, 6° Piso, Laboratorio K, Colonia Tizapan San Ángel, Alcaldía Álvaro Obregón, C.P. 01090, Ciudad de México, MexicoUnidad de Investigación Médica en Medicina Reproductiva, Unidad Médica de Alta Especialidad, Hospital de Gineco Obstetricia No. 4, Luis Castelazo Ayala, Instituto Mexicano del Seguro Social, Río Magdalena 289, 6° Piso, Laboratorio K, Colonia Tizapan San Ángel, Alcaldía Álvaro Obregón, C.P. 01090, Ciudad de México, MexicoUnidad de Investigación Médica en Medicina Reproductiva, Unidad Médica de Alta Especialidad, Hospital de Gineco Obstetricia No. 4, Luis Castelazo Ayala, Instituto Mexicano del Seguro Social, Río Magdalena 289, 6° Piso, Laboratorio K, Colonia Tizapan San Ángel, Alcaldía Álvaro Obregón, C.P. 01090, Ciudad de México, MexicoMany changes occur in the physiology of the maternal thyroid gland to maintain an adequate level of thyroid hormones (THs) at each stage of gestation during normal pregnancy, however, some factors can produce low levels of these hormones, which can alter the onset and progression of pregnancy. Deficiency of THs can be moderate or severe, and classified as overt or clinical hypothyroidism, subclinical hypothyroidism, and isolated hypothyroxinemia. Overt hypothyroidism has been reported in 0.3–1.9% and subclinical hypothyroidism in approximately 1.5–5% of pregnancies. With respect to isolated hypothyroxinemia, the frequency has been reported in approximately 1.3% of pregnant women, however it can be as high as 25.4%. Worldwide, iodine deficiency is the most common cause of hypothyroidism, however, in iodine-sufficient countries like the United States, the most common cause is autoimmune thyroiditis or Hashimoto's thyroiditis. The diagnosis and timely treatment of deficiency of THs (before or during the first weeks of gestation) can significantly reduce some of the related adverse effects, such as recurrent pregnancy loss, preterm delivery, gestational hypertension, and alterations in the offspring. However, so far there is no consensus on the reference levels of thyroid hormones during pregnancy to establish the diagnosis and there is no consensus on universal screening of women during first trimester of pregnancy to identify thyroid dysfunction, to give treatment and to reduce adverse perinatal events, so it is necessary to carry out specific studies for each population that provide information about it. Keywords: Pregnancy, Isolated hypothyroxinemia, Overt hypothyroidism, Subclinical hypothyroidism, Offspringhttp://www.sciencedirect.com/science/article/pii/S1028455919302104 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Eunice López-Muñoz Leovigildo Mateos-Sánchez Gabriel Enrique Mejía-Terrazas Sharon Esperanza Bedwell-Cordero |
spellingShingle |
Eunice López-Muñoz Leovigildo Mateos-Sánchez Gabriel Enrique Mejía-Terrazas Sharon Esperanza Bedwell-Cordero Hypothyroidism and isolated hypothyroxinemia in pregnancy, from physiology to the clinic Taiwanese Journal of Obstetrics & Gynecology |
author_facet |
Eunice López-Muñoz Leovigildo Mateos-Sánchez Gabriel Enrique Mejía-Terrazas Sharon Esperanza Bedwell-Cordero |
author_sort |
Eunice López-Muñoz |
title |
Hypothyroidism and isolated hypothyroxinemia in pregnancy, from physiology to the clinic |
title_short |
Hypothyroidism and isolated hypothyroxinemia in pregnancy, from physiology to the clinic |
title_full |
Hypothyroidism and isolated hypothyroxinemia in pregnancy, from physiology to the clinic |
title_fullStr |
Hypothyroidism and isolated hypothyroxinemia in pregnancy, from physiology to the clinic |
title_full_unstemmed |
Hypothyroidism and isolated hypothyroxinemia in pregnancy, from physiology to the clinic |
title_sort |
hypothyroidism and isolated hypothyroxinemia in pregnancy, from physiology to the clinic |
publisher |
Elsevier |
series |
Taiwanese Journal of Obstetrics & Gynecology |
issn |
1028-4559 |
publishDate |
2019-11-01 |
description |
Many changes occur in the physiology of the maternal thyroid gland to maintain an adequate level of thyroid hormones (THs) at each stage of gestation during normal pregnancy, however, some factors can produce low levels of these hormones, which can alter the onset and progression of pregnancy. Deficiency of THs can be moderate or severe, and classified as overt or clinical hypothyroidism, subclinical hypothyroidism, and isolated hypothyroxinemia. Overt hypothyroidism has been reported in 0.3–1.9% and subclinical hypothyroidism in approximately 1.5–5% of pregnancies. With respect to isolated hypothyroxinemia, the frequency has been reported in approximately 1.3% of pregnant women, however it can be as high as 25.4%. Worldwide, iodine deficiency is the most common cause of hypothyroidism, however, in iodine-sufficient countries like the United States, the most common cause is autoimmune thyroiditis or Hashimoto's thyroiditis. The diagnosis and timely treatment of deficiency of THs (before or during the first weeks of gestation) can significantly reduce some of the related adverse effects, such as recurrent pregnancy loss, preterm delivery, gestational hypertension, and alterations in the offspring. However, so far there is no consensus on the reference levels of thyroid hormones during pregnancy to establish the diagnosis and there is no consensus on universal screening of women during first trimester of pregnancy to identify thyroid dysfunction, to give treatment and to reduce adverse perinatal events, so it is necessary to carry out specific studies for each population that provide information about it. Keywords: Pregnancy, Isolated hypothyroxinemia, Overt hypothyroidism, Subclinical hypothyroidism, Offspring |
url |
http://www.sciencedirect.com/science/article/pii/S1028455919302104 |
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