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

By L. D. De Groot, M. Abalovich, E. Alexander, N. Amino, L. Barbour, R. Cobin, C. Eastman, J. Lazarus, D. Luton, S. Mandel and 3 more. Journal of Clinical Endocrinology and Metabolism, 2007

1,841 citations recorded by the source corpus.

OBJECTIVE The aim was to update the guidelines for the management of thyroid dysfunction during pregnancy and postpartum published previously in 2007. A summary of changes between the 2007 and 2012 version is identified in the Supplemental Data (published on The Endocrine Society's Journals Online web site at http://jcem.endojournals.org). EVIDENCE This evidence-based guideline was developed according to the U.S. Preventive Service Task Force, grading items level A, B, C, D, or I, on the basis of the strength of evidence and magnitude of net benefit (benefits minus harms) as well as the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence. CONSENSUS PROCESS The guideline was developed through a series of e-mails, conference calls, and one face-to-face meeting. An initial draft was prepared by the Task Force, with the help of a medical writer, and reviewed and commented on by members of The Endocrine Society, Asia and Oceania Thyroid Association, and the Latin American Thyroid Society. A second draft was reviewed and approved by The Endocrine Society Council. At each stage of review, the Task Force received written comments and incorporated substantive changes. CONCLUSIONS Practice guidelines are presented for diagnosis and treatment of patients with thyroid-related medical issues just before and during pregnancy and in the postpartum interval. These include evidence-based approaches to assessing the cause of the condition, treating it, and managing hypothyroidism, hyperthyroidism, gestational hyperthyroidism, thyroid autoimmunity, thyroid tumors, iodine nutrition, postpartum thyroiditis, and screening for thyroid disease. Indications and side effects of therapeutic agents used in treatment are also presented.

Subfields: Endocrinology, Diabetes and Metabolism, Public Health, Environmental and Occupational Health

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1. P. Taylor
2. Diana Albrecht
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4. G. Gutiérrez-Buey
5. C. Dayan
6. O. Okosieme
7. J. Lazarus

Citations in the corpus

• Evaluation and treatment of recurrent pregnancy loss: a committee opinion. (2012, background): “As long as thyroid-stimulating hormone (TSH) levels are in the normal range, there is insufficient evidence to recommend routine thyroxine (T4) testing or screening for anti-thyroid antibodies (60).”
• Clinical Practice Guidelines for Hypothyroidism in Adults: Cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association (2012, neutral): “A consensus statement in 2004 (106) and clinical practice guidelines in 2007 (303) and 2011 (10) found insufficient data to support a 1999 (304) and restated 2005 recommendation (305) for universal screening for thyroid dysfunction during pregnancy, but rather recommended aggressive case finding.”
• Global epidemiology of hyperthyroidism and hypothyroidism (2018, positive): “However, a multitude of other risk factors including genetic and ethnic susceptibility, gender 11 , smoking 12 , alcohol consumption 9,13-15 , presence of other auto-immune conditions 16 , syndromic conditions 17 and drug exposures 18,19 also influence thyroid disease epidemiology 20 ( Table 1 ).”
• Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014, neutral): “In addition, two recent consensus documents published by the ATA and the Endocrine Society address the management of hypothyroidism during pregnancy (1,2).”