Abstract:
:In prospective studies, the prevalence of undiagnosed subclinical hypothyroidism in pregnant women ranges from 3% to 15%. Subclinical hypothyroidism is associated with multiple adverse outcomes in the mother and fetus, including spontaneous abortion, pre-eclampsia, gestational hypertension, gestational diabetes, preterm delivery, and decreased IQ in the offspring. Only two prospective studies have evaluated the impact of levothyroxine therapy in pregnant women with subclinical hypothyroidism, and the results were mixed. Subclinical hypothyroidism is defined as raised thyrotropin combined with a normal serum free thyroxine level. The normal range of thyrotropin varies according to geographic region and ethnic background. In the absence of local normative data, the recommended upper limit of thyrotropin in the first trimester of pregnancy is 2.5 mIU/L, and 3.0 mIU/L in the second and third trimester. The thyroid gland needs to produce 50% more thyroid hormone during pregnancy to maintain a euthyroid state. Consequently, most women on levothyroxine therapy before pregnancy require an increase in dose when pregnant to maintain euthyroidism. Ongoing prospective trials that are evaluating the impact of levothyroxine therapy on adverse outcomes in the mother and fetus in women with subclinical hypothyroidism will provide crucial data on the role of thyroid hormone replacement in pregnancy.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Negro R,Stagnaro-Green Adoi
10.1136/bmj.g4929subject
Has Abstractpub_date
2014-10-06 00:00:00pages
g4929eissn
0959-8138issn
1756-1833journal_volume
349pub_type
杂志文章,评审abstract:OBJECTIVE:To examine period trends in the rate of suicide in the first 28 days after discharge from psychiatric hospital. DESIGN:Cohort study of patients discharged from psychiatric hospital. SETTING:Scotland. SUBJECTS:All patients aged 15-84 who were discharged from Scottish psychiatric hospitals during 1968 to 199...
journal_title:BMJ (Clinical research ed.)
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doi:10.1136/bmj.311.7001.357
更新日期:1995-08-05 00:00:00
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journal_title:BMJ (Clinical research ed.)
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更新日期:1996-12-21 00:00:00
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更新日期:2014-12-02 00:00:00
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更新日期:2012-08-08 00:00:00
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更新日期:2008-12-16 00:00:00
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更新日期:1992-05-16 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2012-04-19 00:00:00
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更新日期:2001-05-19 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2008-01-26 00:00:00
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更新日期:2012-07-18 00:00:00
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pub_type: 杂志文章,meta分析
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更新日期:2011-05-24 00:00:00
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pub_type: 杂志文章
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更新日期:2012-03-02 00:00:00
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pub_type: 杂志文章,评审
doi:10.1136/bmj.319.7221.1358
更新日期:1999-11-20 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6655.1007
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更新日期:2020-01-29 00:00:00
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更新日期:2020-10-07 00:00:00
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更新日期:2002-04-27 00:00:00
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pub_type: 杂志文章
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更新日期:2012-09-06 00:00:00