The Need for Dynamic Clinical Guidelines: A Systematic Review of New Research Published After Release of the 2017 ATA Guidelines on Thyroid Disease During Pregnancy and the Postpartum

Conclusion: Based on new research, we recommend the 2017 ATA Guidelines be updated to recommend against treating thyroid antibody-negative women diagnosed with subclinical hypothyroidism in the second trimester or later; to reflect new, moderate-quality evidence supporting the treatment of thyroid peroxidase antibody-negative women with elevated thyroid stimulating hormone levels in the first trimester or earlier; and to recommend against treatment of euthyroid, thyroid peroxidase antibody-positive women undergoing assisted reproductive technology. Transitioning to a Dynamic ATA Guidelines would allow for these and future recommendations to be implemented in real time.
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research

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Authors: Abstract Both thyrotoxicosis and hypothyroidism are associated with adverse pregnancy outcomes. There also is concern about the effect of overt maternal thyroid disease on fetal development. In addition, medications that affect the maternal thyroid gland can cross the placenta and affect the fetal thyroid gland. This document reviews the thyroid-related pathophysiologic changes that occur during pregnancy and the effects of overt and subclinical maternal thyroid disease on maternal and fetal outcomes. This Practice Bulletin has been updated with information on the diagnosis and the management of thyroid ...
Source: Obstetrics and Gynecology - Category: OBGYN Tags: Obstet Gynecol Source Type: research
Authors: Abstract Both thyrotoxicosis and hypothyroidism are associated with adverse pregnancy outcomes. There also is concern about the effect of overt maternal thyroid disease on fetal development. In addition, medications that affect the maternal thyroid gland can cross the placenta and affect the fetal thyroid gland. This document reviews the thyroid-related pathophysiologic changes that occur during pregnancy and the effects of overt and subclinical maternal thyroid disease on maternal and fetal outcomes. This Practice Bulletin has been updated with information on the diagnosis and the management of thyroid ...
Source: Obstetrics and Gynecology - Category: OBGYN Tags: Obstet Gynecol Source Type: research
RARITAN, NJ, May 13, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today results from the final analysis of the pivotal Phase 3 SPARTAN study demonstrating ERLEADA® (apalutamide) in combination with androgen deprivation therapy (ADT) significantly improved overall survival (OS), compared to ADT alone, in patients with non-metastatic castration-resistant prostate cancer (nmCRPC) who were at high risk of developing metastases.[i] Results will be presented at the American Society of Clinical Oncology (ASCO) Virtual Scientific Program (Abstract #5516) beginning May 29th. ERLEADA® i...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
Conclusion: A low serum IL-17A level during the second trimester is associated with an increased risk of TSH> 2.5 mIU/L and subclinical hypothyroidism.
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
CONCLUSIONS: More than one-third of patients with SCH during pregnancy had persistent hypothyroidism after delivery. We recommend that patients with TPOAb positive both during pregnancy and 6-week postpartum undergo close follow-up to detect persistent hypothyroidism, especially before the next pregnancy. PMID: 32375594 [PubMed - as supplied by publisher]
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
Publication date: Available online 29 April 2020Source: Journal of Trace Elements in Medicine and BiologyAuthor(s): Samira Akdader-Oudahmane, Zohra Hamouli-Saïd, Michael B. Zimmermann, Hanane Kherrab, Said Azzoug, Djamila Meskine
Source: Journal of Trace Elements in Medicine and Biology - Category: Biochemistry Source Type: research
Authors: Inagaki Y, Takeshima K, Nishi M, Ariyasu H, Doi A, Kurimoto C, Uraki S, Morita S, Furukawa Y, Inaba H, Iwakura H, Shimokawa T, Utsunomiya T, Akamizu T Abstract Thyroid dysfunction and thyroid autoimmunity (TAI) have been reported to be linked to infertility, pregnancy loss and preterm birth. Infertile women undergoing assisted reproductive technology are recommended to maintain thyroid stimulating hormone (TSH) levels below 2.5 μIU/mL. It is unclear, however, whether levothyroxine (L-T4) treatment decreases the effects of TAI on fertility and pregnancy outcome in infertile women. We therefore aimed to c...
Source: Endocrine Journal - Category: Endocrinology Tags: Endocr J Source Type: research
Authors: Boyanov MA Abstract This review attempts to summarize data on the prevalence of thyroid pathology in the Bulgarian population over a period of 20 years. Thyroid dysfunction was studied in two population-based studies (2006 and 2012). In the first, hypothyroidism was found in 6.3% and hyperthyroidism in 3.7% of the participants. The second study found overt and subclinical hypothyroidism in 3.2% and 4.5%, respectively, of females, and in 1.1% and 2% of males. TPOAb levels were elevated in 23% of females and in 9.6% of males. Nodules were found using ultrasound (US) in 23.4% of the participants in the 2...
Source: Hormones - Category: Endocrinology Tags: Hormones (Athens) Source Type: research
Abstract In consideration of the potential roles of selenoproteins in thyroid function, we aimed to evaluate the association of low selenium status with hypothyroidism during pregnancy and the association of maternal low thyroid function with infant birth size. We conducted a prospective birth cohort study in Shanghai in 2010 and investigated 1931 pregnant mothers of gestational weeks 28-36. Maternal serum selenium and thyrotropin (TSH) levels were determined and birth weights and lengths of newborns were measured. Other covariates were obtained through maternal interviews and medical records. A non-linear associa...
Source: Biological Trace Element Research - Category: Biology Authors: Tags: Biol Trace Elem Res Source Type: research
Postpartum thyroiditis (PPT) has a prevalence of 1–22%, with an ~50% rate of evolution into permanent hypothyroidism (PH). PPT risk is assessed by measuring serum thyroid antibodies during gestation, as 1/3–1/2 of Ab+ve pregnant women will develop PPT. Family and personal history positive for autoimmune non-thyroid diseases (AINTDT), and consumption of swordfish increases while consumption of small oily fish decreases the risk of PPT. Monitoring thyroid function in a very high-risk subgroup avoids the costs of the Ab-based universal screening. We aimed at identifying such subgroup in 412 women followed from wee...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
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