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A 2018 Italian and Romanian Survey on Subclinical Hypothyroidism in Pregnancy.
Eur Thyroid J. 2018 Nov; 7(6):294-301.ET

Abstract

Objectives

Pregnancy induces changes in thyroid function, and thyroid dysfunction during gestation is associated with adverse outcomes. We examined the management of subclinical hypothyroidism and chronic autoimmune thyroiditis in pregnancy among Italian and Romanian endocrinologists.

Methods

Members of the Associazione Medici Endocrinologi (AME) and Romanian Society of Endocrinology (RSE) were invited to participate in a web-based survey investigating the topic.

Results

A total of 902 individuals participated in the survey, 759 of whom completed all sections. Among the respondents, 85.1% were aware of the 2017 American Thyroid Association guidelines about thyroid disease and pregnancy, and 82.9% declared that thyroid-stimulating hormone (TSH) screening at the beginning of pregnancy should be warranted. In a patient negative for peroxidase antibodies, 53.6% considered 2.5 mIU/L and 26.2% considered 4.0 mIU/L as the upper normal limit of TSH, and 50% would treat a patient with TSH 3.5 mIU/L with levothyroxine. About 20% did not suggest iodine supplementation. Isolated hypothyroxinemia detected in the first trimester would be treated by 40.8%. In patients undergoing ovarian stimulation, a TSH < 2.5 mIU/L would be targeted by 70%.

Conclusions

Respondents globally appeared well informed about the management of thyroid autoimmunity and subclinical hypothyroidism in pregnancy. A more aggressive attitude in implementing iodine supplementation would be desirable. Most endocrinologists were convinced about an evident association between mild thyroid impairment and adverse outcomes in pregnancy, thus using a TSH value of 2.5 mIU/L as the threshold for diagnosing hypothyroidism and starting levothyroxine in pregnant women.

Authors+Show Affiliations

Division of Endocrinology, "V. Fazzi" Hospital, Lecce, Italy.Endocrinology Service, Galeazzi Institute IRCCS, Milan, Italy.Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy.Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy.Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria "S. Maria della Misericordia", Udine, Italy.Endocrinology, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Roma, Italy.Department of Endocrinology, Carol Davila University of Medicine of Pharmacy, Bucharest, Romania.Department of Endocrinology, Carol Davila University of Medicine of Pharmacy, Bucharest, Romania.Department of Endocrinology, Carol Davila University of Medicine of Pharmacy, Bucharest, Romania.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30574459

Citation

Negro, Roberto, et al. "A 2018 Italian and Romanian Survey On Subclinical Hypothyroidism in Pregnancy." European Thyroid Journal, vol. 7, no. 6, 2018, pp. 294-301.
Negro R, Attanasio R, Papini E, et al. A 2018 Italian and Romanian Survey on Subclinical Hypothyroidism in Pregnancy. Eur Thyroid J. 2018;7(6):294-301.
Negro, R., Attanasio, R., Papini, E., Guglielmi, R., Grimaldi, F., Toscano, V., Niculescu, D. A., Paun, D. L., & Poiana, C. (2018). A 2018 Italian and Romanian Survey on Subclinical Hypothyroidism in Pregnancy. European Thyroid Journal, 7(6), 294-301. https://doi.org/10.1159/000490944
Negro R, et al. A 2018 Italian and Romanian Survey On Subclinical Hypothyroidism in Pregnancy. Eur Thyroid J. 2018;7(6):294-301. PubMed PMID: 30574459.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A 2018 Italian and Romanian Survey on Subclinical Hypothyroidism in Pregnancy. AU - Negro,Roberto, AU - Attanasio,Roberto, AU - Papini,Enrico, AU - Guglielmi,Rinaldo, AU - Grimaldi,Franco, AU - Toscano,Vincenzo, AU - Niculescu,Dan Alexandru, AU - Paun,Diana Loreta, AU - Poiana,Catalina, Y1 - 2018/07/26/ PY - 2018/05/17/received PY - 2018/06/15/revised PY - 2018/12/22/entrez PY - 2018/12/24/pubmed PY - 2018/12/24/medline KW - Autoimmunity KW - Guidelines KW - Hypothyroidism KW - Pregnancy KW - Survey KW - Thyroid SP - 294 EP - 301 JF - European thyroid journal JO - Eur Thyroid J VL - 7 IS - 6 N2 - Objectives: Pregnancy induces changes in thyroid function, and thyroid dysfunction during gestation is associated with adverse outcomes. We examined the management of subclinical hypothyroidism and chronic autoimmune thyroiditis in pregnancy among Italian and Romanian endocrinologists. Methods: Members of the Associazione Medici Endocrinologi (AME) and Romanian Society of Endocrinology (RSE) were invited to participate in a web-based survey investigating the topic. Results: A total of 902 individuals participated in the survey, 759 of whom completed all sections. Among the respondents, 85.1% were aware of the 2017 American Thyroid Association guidelines about thyroid disease and pregnancy, and 82.9% declared that thyroid-stimulating hormone (TSH) screening at the beginning of pregnancy should be warranted. In a patient negative for peroxidase antibodies, 53.6% considered 2.5 mIU/L and 26.2% considered 4.0 mIU/L as the upper normal limit of TSH, and 50% would treat a patient with TSH 3.5 mIU/L with levothyroxine. About 20% did not suggest iodine supplementation. Isolated hypothyroxinemia detected in the first trimester would be treated by 40.8%. In patients undergoing ovarian stimulation, a TSH < 2.5 mIU/L would be targeted by 70%. Conclusions: Respondents globally appeared well informed about the management of thyroid autoimmunity and subclinical hypothyroidism in pregnancy. A more aggressive attitude in implementing iodine supplementation would be desirable. Most endocrinologists were convinced about an evident association between mild thyroid impairment and adverse outcomes in pregnancy, thus using a TSH value of 2.5 mIU/L as the threshold for diagnosing hypothyroidism and starting levothyroxine in pregnant women. SN - 2235-0640 UR - https://www.unboundmedicine.com/medline/citation/30574459/A_2018_Italian_and_Romanian_Survey_on_Subclinical_Hypothyroidism_in_Pregnancy_ L2 - https://www.karger.com?DOI=10.1159/000490944 DB - PRIME DP - Unbound Medicine ER -
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