Autoimmune thyroiditis and pregnancy: changes in the modern diagnostic and therapeutic paradigms

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A sufficient level of thyroid hormones is crucial for normal course of pregnancy and fetal development. It has been proven that even subclinical thyroid dysfunction during pregnancy is associated with adverse outcomes for both mother and baby. The leading role in the development of thyroid dysfunction belongs to overt hypothyroidism in the outcome of autoimmune thyroiditis. Despite the progress achieved in the study of pathogenesis of this disease and the wide possibilities of using advanced laboratory technologies, there are currently a lot of diagnostic and clinical issues and uncertainties. Role of such markers, such as anti-TPO, thyroglobulin antibodies in the development and progression of hypothyroidism associated with obstetric complications and neuropsychiatric disorders in child. Also relevant is the issue of using high performance liquid chromatography MS/MS — tandem mass spectrometry (MS/MS) to develop trimester-specific intervals for thyroid hormones during pregnancy. In 2017, updated clinical guidelines were issued, in which experts discuss new reference values of TSH for pregnant women with an emphasis on ethnic features of the population. These recommendations change the diagnostic criteria and indications for initiating levothyroxine replacement therapy for treatment of hypothyroidism in pregnant women.

Keywords:

pregnancy

thyroid gland

autoimmunity

hypothyroidism

Authors:

Platonova N.M.

Endocrinology Research Centre, Moscow, Russia

Makolina N.P.

FGBU Éndokrinologicheskiĭ nauchnyĭ tsentr Minzdravsotsrazvitiia RF, Moskva

Rybakova A.A.

Endocrinology Research Centre, Moscow, Russia

Troshina E.A.

Éndokrinologicheskiĭ nauchnyĭ tsentr, Moskva

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