Indications for treatment of subclinical hypothyroidism and isolated hypothyroxinaemia in pregnancy

Best Pract Res Clin Endocrinol Metab. 2020 Jul;34(4):101436. doi: 10.1016/j.beem.2020.101436. Epub 2020 Jun 18.

Abstract

Thyroid hormones are essential for maintaining a pregnancy and optimal fetal neurological development. Pregnancy places additional demands on the thyroid axis and around 5% of women who have their thyroid function checked during gestation will have borderline low thyroid function (subclinical hypothyroidism or isolated hypothyroxinemia) identified. These borderline low thyroid states are associated with adverse obstetric and offspring outcomes. Whilst it is well established that overt hypothyroidism requires treatment with levothyroxine, it is less clear whether there is any benefit of treating borderline low thyroid states. This review summarizes the potential indications for treatment of subclinical hypothyroidism and isolated hypothyroxinemia.

Keywords: isolated hypothyroxinemia; levothyroxine; pregnancy; screening; subclinical hypothyroidism.

Publication types

  • Review

MeSH terms

  • Asymptomatic Diseases
  • Female
  • Humans
  • Hypothyroidism / blood
  • Hypothyroidism / complications
  • Hypothyroidism / therapy*
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Complications / therapy*
  • Prenatal Care* / methods
  • Prenatal Care* / standards
  • Thyroid Hormones / blood
  • Thyroxine / therapeutic use

Substances

  • Thyroid Hormones
  • Thyroxine