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Thyroid and pregnancy

Natalie M Crawford, Anne Z Steiner
Thyroid hormones are important for normal reproductive function, and maternal thyroid dysfunction has been associated with infertility, miscarriage, preterm birth, and poor neurodevelopment in the offspring. Thyroid autoimmunity is the leading cause of thyroid dysfunction in women of reproductive age. Women with thyroid autoimmunity, even with normal thyroid function, appear to be at a higher risk for poor reproductive outcomes, including miscarriage and preterm birth. Thyroxine replacement in women with thyroid autoimmunity with or without appreciable thyroid dysfunction may improve pregnancy outcomes...
October 17, 2016: Seminars in Reproductive Medicine
Sophia S Yu, Lindsay A Bischoff
Owing to the young median age of diagnosis, thyroid cancer in women can coincide with pregnancy and affect its management. The evaluation of a thyroid nodule in pregnant women is similar to that in nonpregnant women, but special consideration must be taken for the impact of a cancer diagnosis and its sequelae in pregnancy. The initial comprehensive exam for pregnant and nonpregnant women includes evaluation of the biochemical function and structure of the thyroid gland, and then fine-needle aspiration biopsy of any suspicious nodule...
October 14, 2016: Seminars in Reproductive Medicine
Aimee Seungdamrong
Subclinical hypothyroidism has been found to be associated with adverse reproductive outcomes, such as infertility, miscarriage, preterm birth, and complications of pregnancy. Multiple studies have investigated the relationships between thyroid function, thyroid antibodies, fertility, and pregnancy. Thyroid autoimmunity is the most common cause of hypothyroidism in iodine-sufficient locations. Thyroid antibodies have been associated with adverse reproductive outcomes such as miscarriage and infertility. Debate exists regarding the method of identification of thyroid dysfunction in pregnancy, which can be conducted by targeted screening or by universal screening...
October 14, 2016: Seminars in Reproductive Medicine
Sudipa Sarkar, Lindsay A Bischoff
Hyperthyroidism can occur during pregnancy and the postpartum period, and the treatment of hyperthyroidism should be considered in the preconception phase. Pregnancy has multiple normal physiologic effects on thyroid hormone, which is a separate process distinct from syndromes such as transient hyperthyroidism of hyperemesis gravidarum. The rationale regarding antithyroid drug use during different stages of pregnancy is reviewed, including the literature regarding adverse neonatal outcomes such as aplasia cutis and methimazole embryopathy in the setting of first trimester maternal methimazole use...
October 14, 2016: Seminars in Reproductive Medicine
Jeffrey M Kroopnick, Caroline S Kim
Overt hypothyroidism in pregnancy, defined as an elevated serum thyroid-stimulating hormone (TSH) and reduced serum free thyroxine or a TSH >10 mIU/L, is known to have adverse effects on pregnancy. Subclinical hypothyroidism is typically defined as an elevated TSH and normal FT4 levels. There remains much controversy on the benefit of starting levothyroxine for mothers diagnosed with subclinical hypothyroidism. Recent studies are redefining the normal range for TSH in pregnancy, and the data on whether treatment of subclinical hypothyroidism improves outcomes for the mother and fetus are unclear...
October 14, 2016: Seminars in Reproductive Medicine
Xiaomei Zhang, Baoting Yao, Chenyan Li, Jinyuan Mao, Weiwei Wang, Xiaochen Xie, Xiaochun Teng, Cheng Han, Weiwei Zhou, Chenyang Li, Bin Xu, Lihua Bi, Tao Meng, Jianling Du, Shaowei Zhang, Zhengnan Gao, Liu Yang, Chenling Fan, Weiping Teng, Zhongyan Shan
BACKGROUND: Self-sequential longitudinal reference interval may be expected to minimize the inter-individual variation of thyroid function. Comparison between self-sequential longitudinal reference interval and cross-sectional reference interval in pregnancy has not been well investigated. The objective of this study is to establish a stringent self-sequential longitudinal reference interval (SLRI) of thyroid function in pregnant women and to compare it with the conventional cross-sectional reference interval (CSRI)...
October 12, 2016: Thyroid: Official Journal of the American Thyroid Association
Eric De Zoysa, Manjula Hettiarachchi, Chandrani Liyanage
BACKGROUND: Iodine deficiency and thyroid dysfunction during pregnancy is associated with number of adverse outcomes that includes mental and physical disabilities creating a huge human and economic burden in later life. Several indicators are used to assess the iodine status of a population: thyroid size by palpation and/or by ultrasonography, urinary iodine excretion and the blood thyroid hormone profile. METHODS: This prospective study was designed to assess the iodine nutrition during the course of pregnancy with reference to urine iodine concentration (UIC) and thyroid determinants among 425 pregnant women from Galle district, Sri Lanka...
October 12, 2016: BMC Pregnancy and Childbirth
Myrthe M van Dijk, Rosa Vissenberg, Peter H Bisschop, Feroza Dawood, Madelon van Wely, Mariëtte Goddijn, Roy G Farquharson
Thyroid disorders have been associated with recurrent miscarriage. Little evidence is available on the influence of subclinical hypothyroidism on live birth rates. In this cohort study, women who had experienced miscarriage and subclinical hypothyroidism (defined as thyroid-stimulating hormone >97.5th percentile mU/l with a normal thyroxine level) were investigated; the control group included women who had experienced recurrent miscarriage and normal thyroid function. Multivariable logistic regression was used to investigate the association of subclinical hypothyroidism...
September 20, 2016: Reproductive Biomedicine Online
Shalini D Soechitram, Sietske A Berghuis, Theo J Visser, Pieter J J Sauer
BACKGROUND: Several studies have shown effects of polychlorinated biphenyls (PCBs) on serum thyroid hormone levels in pregnant woman and their infants, while other studies did not find such effects. How PCBs might affect thyroid hormone metabolism, is still unclear. Potential mechanisms are direct influence on the thyroid gland, binding to thyroid binding proteins, increased excretion or metabolism of thyroid hormones by deiodinases or sulfatases. It is also not well known whether the effect on thyroid hormone levels is caused by PCBs themselves, or by their hydroxylated metabolites (OH-PCBs)...
October 3, 2016: Science of the Total Environment
Christopher K Thompson, Hollis T Cline
: Thyroid hormone (TH) regulates many cellular events underlying perinatal brain development in vertebrates. Whether and how TH regulates brain development when neural circuits are first forming is less clear. Furthermore, although the molecular mechanisms that impose spatiotemporal constraints on TH action in the brain have been described, the effects of local TH signaling are poorly understood. We determined the effects of manipulating TH signaling on development of the optic tectum in stage 46-49 Xenopus laevis tadpoles...
October 5, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Stine Linding Andersen, Peter Laurberg
Hyperthyroidism in women who are of childbearing age is predominantly of autoimmune origin and caused by Graves' disease. The physiological changes in the maternal immune system during a pregnancy may influence the development of this and other autoimmune diseases. Furthermore, pregnancy-associated physiological changes influence the synthesis and metabolism of thyroid hormones and challenge the interpretation of thyroid function tests in pregnancy. Thyroid hormones are crucial regulators of early development and play an important role in the maintenance of a normal pregnancy and in the development of the fetus, particularly the fetal brain...
2016: International Journal of Women's Health
Melahat Atasever, Muberra Namli Kalem, Çiğdem Sönmez, Mehmet Murat Seval, Seda Sahin Aker, Tuncay Yuce, Acar Koç, Hakan Genc
OBJECTIVE: The aim of the study is to investigate the relationship between changes in serotonin levels during pregnancy and fibromyalgia syndrome(FS) and the relationships between FS and the physical/psychological state, biochemical and hormonal parameters, which may be related to the musculoskeletal system. STUDY DESIGN: This study is a prospective case-control study conducted with 277 pregnant women at the obstetric unit of Ankara University Faculty of Medicine, in the period between January and June 2015...
October 3, 2016: Journal of Maternal-fetal & Neonatal Medicine
Nissim Arbib, Eran Hadar, Orly Sneh-Arbib, Rony Chen, Arnon Wiznitzer, Rinat Gabbay-Benziv
PURPOSE: Maternal thyroid gland dysfunction may adversely affect pregnancy outcome. We aimed to examine the association between subclinical thyroid dysfunction, both hypothyroidism and hyperthyroidism, to adverse pregnancy outcome. MATERIALS AND METHODS: Retrospective cohort study of all women with an available first trimester thyroid function testing and known pregnancy outcome, categorized to subclinical hypothyroidism, or hyperthyroidism and evaluated for complication during gestation and delivery...
October 17, 2016: Journal of Maternal-fetal & Neonatal Medicine
Gi Su Lee, Joon Cheol Park, Jeong Ho Rhee, Jong In Kim
OBJECTIVE: The goal of this study was to evaluate the etiologies and clinical outcomes of Korean recurrent pregnancy loss (RPL) patients. And also, we investigated the differences between primary and secondary RPL patients, between two and three or more pregnancy losses. METHODS: One hundred seventy eight women diagnosed as RPL were enrolled. We performed chromosomal analysis, thyroid stimulating hormone, prolactin, blood glucose, plasminogen activator inhibitor-1, natural killer cell proportion, anticardiolipin antibodies, antiphospholipid antibodies, lupus anticoagulant, anti-β2glycoprotein-1 antibodies, antinuclear antibody, protein C, protein S, antithrombin III, homocysteine, MTFHR gene, factor V Leiden mutation, and hysterosalphingography/hysteroscopic evaluation...
September 2016: Obstetrics & Gynecology Science
Marlena Schoenberg Fejzo, Ronny Myhre, Lucia Colodro-Conde, Kimber Macgibbon, Janet S Sinsheimer, M V Prasad Linga Reddy, Päivi Pajukanta, Dale R Nyholt, Margaret J Wright, Nicholas G Martin, Stephanie M Engel, Sarah E Medland, Per Magnus, Patrick M Mullin
Hyperemesis Gravidarum (HG), severe nausea/vomiting in pregnancy (NVP), can cause poor maternal/fetal outcomes. Genetic predisposition suggests the genetic component is essential in discovering an etiology. We performed whole-exome sequencing of 5 families followed by analysis of variants in 584 cases/431 controls. Variants in RYR2 segregated with disease in 2 families. The novel variant L3277R was not found in any case/control. The rare variant, G1886S was more common in cases (p = 0.046) and extreme cases (p = 0...
September 20, 2016: Molecular and Cellular Endocrinology
Tim I M Korevaar, Peter N Taylor, Colin M Dayan, Robin P Peeters
No abstract text is available yet for this article.
October 2016: Obstetrics and Gynecology
Erling Thom
Postpartum effluvium is a well-known clinical fact. However, following some minor research activities in the 1960s, very little has happened on the research front of the subject. It was hypothesized that postpartum hair loss might be a manifestation of a change in the hair growth cycle occurring normally during pregnancy. Recently, new research has been published trying to explain the mechanism of action behind this frequently occurring hair growth disruption, and to develop a functional treatment schedule and regime...
September 23, 2016: Journal of Cosmetic Dermatology
Manas Kumar Sahoo
No abstract text is available yet for this article.
September 2016: World Journal of Nuclear Medicine
Qiushi Wang, Chongdong Liu, Zhenyu Zhang
Since transthyretin (TTR) was discovered, it has been regarded as a serum protein carrier of thyroid hormones and retinol. However, many other important functions of TTR have been found recently, and current evidence suggests that it plays a role in human receptivity and normal pregnancy. TTR is abundant in the uterine cavity, uterine secretion, placenta, and serum of pregnant females in the peri-implantation uterus and the first trimester of pregnancy. It may be involved in the delivery of maternal thyroid hormones to the fetus...
2016: Critical Reviews in Eukaryotic Gene Expression
Tim I M Korevaar, Eric A P Steegers, Layal Chaker, Marco Medici, Vincent W V Jaddoe, Theo J Visser, Yolanda B de Rijke, Robin P Peeters
CONTEXT: During pregnancy, there is an increased demand for thyroid hormone. The pregnancy hormone human chorionic gonadotropin (hCG) is an important physiological stimulator of thyroid function. Already high-normal maternal FT4 concentrations are associated with a higher risk of pre-eclampsia. OBJECTIVE: To study our hypothesis that hCG concentrations can distinguish a physiological form of high thyroid function from a more pathological form of high thyroid function, and that the risk of pre-eclampsia would differ accordingly...
September 20, 2016: Journal of Clinical Endocrinology and Metabolism
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