title: Individualized Follow-up of Pregnant Women with Asymptomatic Autoimmune Thyroid Disease.
abstract: Maternal hormones are essential for the normal fetal development during pregnancy. Autoimmune thyroid disease is a frequent pathology in our iodine replete region. The aim of this study is to evaluate the occurrence of subclinical hypothyroidism (SCH) in cases with known autoimmune thyroid disease, which were in a euthyroid state prior to pregnancy, and to assess the association between supplemental treatments administered and the outcome of the pregnancy. The study is a prospective interventional controlled study. The two cohorts comprise the interventional group, consisting of 109 pregnant women with known autoimmune asymptomatic thyroid disease, without any levothyroxine (LT4) treatment and an aged-matched control group, with an unknown thyroid disease. After the pregnancy, a monthly evaluation of TSH, FT3, and FT4 was performed. Offspring evaluation was made at birth time. 88.8% of the women developed SCH in the first four weeks of pregnancy. Average LT4 doses increased as the pregnancy progressed. The monthly adjustment was 12.5 or 25 μg. All SCH cases developed in the first trimester of pregnancy. There was no significant difference regarding the gestational week, weight, or length at birth between the interventional group and controls, when TSH values were in the optimal range, during the whole pregnancy. Premature birth was described in one case in the interventional group.
authors.affiliation: Obstetrics Gynecology Department, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2nd Eftimie Murgu Sq., Timisoara 300041, Romania. stoian.dana@umft.ro.
authors.forename: Dana
authors.initials: D
authors.lastname: Stoian
authors.affiliation: Surgery Department, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2nd Eftimie Murgu Sq., Timisoara 300041, Romania. stepan62@yahoo.com.
authors.forename: Stelian
authors.initials: S
authors.lastname: Pantea
authors.affiliation: Obstetrics Gynecology Department, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2nd Eftimie Murgu Sq., Timisoara 300041, Romania. marganmm@gmail.com.
authors.forename: Madalin
authors.initials: M
authors.lastname: Margan
authors.affiliation: Medical Informatics Department, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2nd Eftimie Murgu Sq., Timisoara 300041, Romania. timar.bogdan@umft.ro.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Timar
authors.affiliation: Analytical Chemistry Department, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2nd Eftimie Murgu Sq., Timisoara 300041, Romania. fborcan@umft.ro.
authors.forename: Florin
authors.initials: F
authors.lastname: Borcan
authors.affiliation: Obstetrics Gynecology Department, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2nd Eftimie Murgu Sq., Timisoara 300041, Romania. craina.marius@umft.ro.
authors.forename: Marius
authors.initials: M
authors.lastname: Craina
authors.affiliation: Microbiology Department, "Victor Babes" University of Medicine and Pharmacy Timisoara, 2nd Eftimie Murgu Sq., Timisoara 300041, Romania. craciunescu.mihaela@umft.ro.
authors.forename: Mihaela
authors.initials: M
authors.lastname: Craciunescu
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D001323:Autoantibodies / Q000097:blood*; D016022:Case-Control Studies; D016903:Drug Monitoring; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D057285:Precision Medicine; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011446:Prospective Studies; D013961:Thyroid Gland / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D013967:Thyroiditis, Autoimmune / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use*; D014284:Triiodothyronine / Q000097:blood
chemical_list: D001323:Autoantibodies; D014284:Triiodothyronine; D013972:Thyrotropin; D013974:Thyroxine
keywords: autoimmune thyroid disease; follow-up; pregnancy; subclinical hypothyroidism; supplemental therapy