Volume 33, Issue 3, August 2021, Pages 536–540
R. Watfeh1, Karima Matar2, K. Tamim3, M. Youssfi4, and Samir Bargach5
1 Service de Gynécologie-Obstétrique, de Cancérologie et de Grossesses à Haut Risque, Maternité Souissi, Université Mohamed V, Rabat, Morocco
2 Service de gynécologie obstétrique de cancérologie et de grossesse à haut risque, Maternité souissi, Université Mohammed V, Rabat, Morocco
3 Department of Gynecology-obstetrics, oncology and high-risk pregnancies, Souissi Maternity Hospital, Mohamed V University, Rabat, Morocco
4 Department of Gynecology-obstetrics, oncology and high-risk pregnancies, Souissi Maternity Hospital, Mohamed V University, Rabat, Morocco
5 Department of Gynecology-Obstetrics-Oncology and High-Risk Pregnancy, Souissi Maternity Hospital, Ibn Sina University Hospital Center, Rabat, Morocco
Original language: English
Copyright © 2021 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
It is estimated that more than 2% of pregnant women have hypothyroidism and that the incidence of treated hypothyroidism prior to pregnancy is around 0.3% of pregnancies. In the majority of cases, hypothyroidism is mild and is due to an autoimmune mechanism, as evidenced by the presence of anti-TPO or antithyroglobulin antibodies. Pregnancy may be indicative of a fruste form, related to asymptomatic autoimmune thyroiditis, which is unable to increase its hormone production to meet the specific needs of pregnancy. It can also be the consequence of moderate or severe iodine deficiency. Moreover, thyroid balance during pregnancy is essential for good fetal brain development. In fact, several studies have shown that children born to mothers who are not or insufficiently substituted for hypothyroidism have lower intelligence quotients than the general population. In addition, other maternal consequences (gravid hypertension, pre-eclampsia, etc.) and fetal consequences (IUGR, intellectual deficit) of hypothyroidism during pregnancy have been described. Although current recommendations suggest targeted screening of patients at risk of hypothyroidism, it is desirable that, in the near future, this screening becomes systematic as soon as the diagnosis of pregnancy is confirmed. L-thyroxine treatment should then be rapidly initiated (or adapted in the case of known hypothyroidism prior to pregnancy) with the aim of achieving a TSH of less than 2.5 mIU/l. In all cases, iodine supplementation should be offered from the preconceptional period through to breastfeeding.
Author Keywords: Hypothyroidism, Pregnancy, Iodine deficiency, Antithyroid antibodies, Thyroid autoimmunity.
R. Watfeh1, Karima Matar2, K. Tamim3, M. Youssfi4, and Samir Bargach5
1 Service de Gynécologie-Obstétrique, de Cancérologie et de Grossesses à Haut Risque, Maternité Souissi, Université Mohamed V, Rabat, Morocco
2 Service de gynécologie obstétrique de cancérologie et de grossesse à haut risque, Maternité souissi, Université Mohammed V, Rabat, Morocco
3 Department of Gynecology-obstetrics, oncology and high-risk pregnancies, Souissi Maternity Hospital, Mohamed V University, Rabat, Morocco
4 Department of Gynecology-obstetrics, oncology and high-risk pregnancies, Souissi Maternity Hospital, Mohamed V University, Rabat, Morocco
5 Department of Gynecology-Obstetrics-Oncology and High-Risk Pregnancy, Souissi Maternity Hospital, Ibn Sina University Hospital Center, Rabat, Morocco
Original language: English
Copyright © 2021 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
It is estimated that more than 2% of pregnant women have hypothyroidism and that the incidence of treated hypothyroidism prior to pregnancy is around 0.3% of pregnancies. In the majority of cases, hypothyroidism is mild and is due to an autoimmune mechanism, as evidenced by the presence of anti-TPO or antithyroglobulin antibodies. Pregnancy may be indicative of a fruste form, related to asymptomatic autoimmune thyroiditis, which is unable to increase its hormone production to meet the specific needs of pregnancy. It can also be the consequence of moderate or severe iodine deficiency. Moreover, thyroid balance during pregnancy is essential for good fetal brain development. In fact, several studies have shown that children born to mothers who are not or insufficiently substituted for hypothyroidism have lower intelligence quotients than the general population. In addition, other maternal consequences (gravid hypertension, pre-eclampsia, etc.) and fetal consequences (IUGR, intellectual deficit) of hypothyroidism during pregnancy have been described. Although current recommendations suggest targeted screening of patients at risk of hypothyroidism, it is desirable that, in the near future, this screening becomes systematic as soon as the diagnosis of pregnancy is confirmed. L-thyroxine treatment should then be rapidly initiated (or adapted in the case of known hypothyroidism prior to pregnancy) with the aim of achieving a TSH of less than 2.5 mIU/l. In all cases, iodine supplementation should be offered from the preconceptional period through to breastfeeding.
Author Keywords: Hypothyroidism, Pregnancy, Iodine deficiency, Antithyroid antibodies, Thyroid autoimmunity.
How to Cite this Article
R. Watfeh, Karima Matar, K. Tamim, M. Youssfi, and Samir Bargach, “Impact of hypothyroidism on pregnancy,” International Journal of Innovation and Applied Studies, vol. 33, no. 3, pp. 536–540, August 2021.
