Dont Escape Detection of Hypothyroidism During Pregnancy
Thyroid hormones are released from the gland and travel through the bloodstream to your body's cells. They help control the growth and the structure of bones, sexual development (puberty), and many other body functions. By helping your cells convert oxygen and calories into the energy they need to work properly, these hormones are important in determining if your body will mature as it should. Thyroid hormones also directly affect how most of your organs function. So if your thyroid isn't operating properly, you can have problems in lots of other parts of your body.
Hypothyroidism is the condition in which the thyroid is underactive (i.e., it is producing an insufficient amount of thyroid hormones). Hypothyroidism is the most common thyroid disorder. Severe hypothyroidism can lead to a condition called myxedema, characterized by dry, thickened skin and coarse facial features.Secondary hypothyroidism occurs if the pituitary gland does not create enough thyroid stimulating hormone (TSH) to induce the thyroid gland to create a sufficient quantity of thyroxine.
The most common cause of hypothyroidism is an autoimmune reaction, where the body produces antibodies against the thyroid gland.Symptoms of hypothyroidism are usually very subtle and gradual and may be mistaken for symptoms of depression.Some have few overt symptoms, others with moderate symptoms can be mistaken for having other diseases and states. Hypothyroidism can also result from sporadic inheritance, sometimes autosomal recessive. It is a relatively common disease in purebred domestic dogs as well, and can have a hereditary basis in dogs.
It's important to get a thyroid problem under control before you get pregnant. In fact, anyone with symptoms of thyroid disease such as fatigue, weight loss, or weight gain should have thyroid testing before they conceive, or as soon as possible after they become pregnant. Women who have a family history of thyroid disease or other autoimmune disorders such as type 1 diabetes, rheumatoid arthritis, or lupus should also be screened before trying to conceive.Thyroid problems could affect your ability to get pregnant if the condition is severe enough to disrupt your menstrual cycle.
About 2 percent of adult women in the United States have hypothyroidism. If it's treated inadequately, you may be at an increased risk for placental abruption, an underweight or stillborn infant, or preeclampsia. Some studies suggest that lack of adequate treatment for hypothyroidism in the first trimester could have an effect on the baby's brain development.
Screening only pregnant women felt to be at high-risk for thyroid problems may mean that many women with thyroid dysfunction may escape detection, according to UK researchers.
There is increasing evidence that even a mild "hypothyroidism" during pregnancy is associated with impaired neurological and psychological development of children, lead investigator Dr. Bijay Vaidya told Reuters Health.
"Whilst there is general consensus that thyroid deficiency -- overt and mild -- during pregnancy should be promptly and adequately treated ... to prevent these adverse outcomes, current guidelines do not recommend universal screening of thyroid function in all pregnant women," he noted. "The guidelines recommend testing thyroid function only in high-risk pregnant women."
To gauge the impact of this policy, Vaidya, of Devon and Exeter Hospital, Exeter, and colleagues prospectively studied pregnant women.
At a median of 9 weeks of gestation, they checked thyroid hormone levels in 1,327 women. Of this group, 413 were deemed to be at high risk for abnormal thyroid function because of a personal history of thyroid or other autoimmune disorders or a family history of thyroid disorders.
Forty women (2.6 percent) had raised thyroid-stimulating hormone (TSH) levels. This amounted to 6.8 percent of the high-risk group and 1 percent of the low-risk group. Specific risk factors included a personal history of thyroid problems or a family history of such disorders.
However, the researchers point out that 12 of this group of women with raised TSH (30 percent) were not considered to be at high risk.
Thus, concluded, Vaidya, "our study shows that without universal thyroid screening, about one-third of the pregnant women with thyroid deficiency will be missed."
In an accompanying editorial, Dr. Gregory A. Brent of the University of California, Los Angeles, notes that as tools to diagnose and intervene are easily accessible, leaving mom's thyroid disease undiagnosed "is no longer acceptable."