Document Detail


Thyroid dysfunction in pregnancy: the basic science and clinical evidence surrounding the controversy in management.
MedLine Citation:
PMID:  19300337     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Maternal hypothyroidism is known to result in neurodevelopmental disorders in offspring, but whether subclinical hypothyroidism results in lower intelligence quotient (IQ) performance in progeny is an area of debate. Animal studies have shown that fetal thyroxine and triiodothyronine are primarily maternally derived before mid gestation. Other animal data reveal that fetal brain damage at a time that is analogous to the first trimester in humans can be linked to irreversible future brain damage. A large study conducted on an unselected population of pregnant women, both with known diagnosis of hypothyroidism and those who were screened but not diagnosed, found a four-point difference in the IQ levels of the offspring, raising the question of clinical significance. The endocrine community has accepted that subclinical hypothyroidism causes a significant decrease in IQ scores and has advocated for routine screening of pregnant women. However, obstetric authorities have cautioned that more research is needed before a causal relationship between subclinical hypothyroidism and lower IQ performance can be verified. Consequently, the American College of Obstetricians and Gynecologists has stated that routine screening and treatment of subclinical hypothyroidism cannot be recommended. We will review the basic science and clinical evidence for the neurodevelopmental effects of thyroid dysfunction in pregnancy.
Authors:
Cynthia Gyamfi; Ronald J Wapner; Mary E D'Alton
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  113     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-20     Completed Date:  2009-04-14     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  702-7     Citation Subset:  AIM; IM    
Affiliation:
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York 10032, USA. cg2231@columbia.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Animals
Brain / embryology*,  physiopathology
Child
Child Development / physiology
Female
Fetus / physiopathology
Humans
Hypothyroidism / physiopathology*
Intelligence
Pregnancy
Pregnancy Complications / physiopathology*
Thyroid Hormones / physiology
Chemical
Reg. No./Substance:
0/Thyroid Hormones
Comments/Corrections
Comment In:
Obstet Gynecol. 2009 Jun;113(6):1372, author reply 1372-3   [PMID:  19461445 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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