title: Thyroid (dys-)function in normal and disturbed pregnancy.
abstract: BACKGROUND
  During pregnancy, physiologic changes in maternal thyroid function take place especially due to hormonal as well as metabolic processes. Human chorionic gonadotropin activates the maternal thyroid gland leading to increased thyroid hormone production. A sufficient availability of maternal thyroid hormones is essential for fetal development, especially during the first trimester of pregnancy, when the fetal thyroid gland is not yet functional.
  
  
  METHODS
  Current knowledge of thyroid dysfunction including thyroid autoimmunity, hypothyroidism or hyperthyroidism is summarized with special focus on miscarriage and pregnancy disorders. Therefore, a Medline research as well as an analysis of current guidelines on thyroid function and pregnancy was performed.
  
  
  RESULTS
  A study focusing on TSH levels in normal and disturbed pregnancies, the risk of miscarriage in association with thyroid autoantibodies, and (subclinical) hypothyroidism in infertile and fertile women were included.
  
  
  CONCLUSIONS
  Maternal thyroid dysfunction negatively affects pregnancy outcome. Besides a routine iodine supplementation in pregnant women and treatment of hypo as well as hyperthyroidism, TSH levels should routinely be measured in women during childbearing years and adjusted to concentrations <2.5 mIU/l in order to optimize maternal health and fetal development.
authors.affiliation: Department of Obstetrics and Gynecology, Ludwig-Maximilians University, Maistraße 11, 80337 Munich, Germany.
authors.forename: Brigitte K
authors.initials: BK
authors.lastname: Budenhofer
authors.forename: Nina
authors.initials: N
authors.lastname: Ditsch
authors.forename: Udo
authors.initials: U
authors.lastname: Jeschke
authors.forename: Roland
authors.initials: R
authors.lastname: Gärtner
authors.forename: Bettina
authors.initials: B
authors.lastname: Toth
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D001323:Autoantibodies / Q000097:blood; D005260:Female; D047109:Fetal Development; D005315:Fetal Diseases / Q000209:etiology; D006111:Graves Disease / Q000150:complications; D050031:Hashimoto Disease / Q000150:complications; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications / Q000188:drug therapy; D007037:Hypothyroidism / Q000150:complications / Q000188:drug therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D013959:Thyroid Diseases / Q000150:complications* / Q000276:immunology / Q000503:physiopathology; D013961:Thyroid Gland / Q000276:immunology / Q000503:physiopathology; D013972:Thyrotropin / Q000097:blood
chemical_list: D001323:Autoantibodies; D013972:Thyrotropin