The effects of maternal thyroid hormone function on early pregnancy

PURPOSE OF REVIEW: It is unclear whether pregnancy outcomes are impacted by nonovert thyroid disease, and whether detection and treatment of abnormalities improve outcomes. Consequently, there is an ongoing debate regarding universal thyroid screening in pregnancy. A lack of solid evidence has prompted researchers to evaluate the role of screening and to examine pregnancy outcomes in women with thyroid dysfunction. In addition, as IVF has developed into a commonly used procedure, its impact on thyroid function has also been investigated. The most current literature on these topics will be summarized in this review. RECENT FINDINGS: The multiple societies that have published guidelines on thyroid disease in pregnancy have developed different recommendations, with none definitively advocating for universal screening at this time. However, recent studies examining the role of screening have supported it from an economic and prevalence standpoint. Despite this, evidence has failed to consistently demonstrate that treatment of nonovert thyroid disorders improves maternal and fetal outcomes. Recent research does suggest that close monitoring for and treatment of thyroid dysfunction is warranted in women undergoing IVF. SUMMARY: Further research must be performed to determine whether treatment of nonovert thyroid disease during pregnancy impacts outcomes. Concrete evidence will likely influence the universal screening debate.