Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Apr 2;11(1):9.
doi: 10.1186/s40748-025-00208-9.

Overview of thyroid disorders in pregnancy

Mohammed Ashraf Puthiyachirakal  1 , Maeve Hopkins  2 , Tala AlNatsheh  3 , Anirudha Das  4
Affiliations
Review

Overview of thyroid disorders in pregnancy

Mohammed Ashraf Puthiyachirakal et al. Matern Health Neonatol Perinatol. .

Abstract

Thyroid disorders rank as the second most common endocrine abnormalities during pregnancy, posing significant challenges for clinical diagnosis due to overlapping symptoms with normal pregnancy. Thyroid hormones play a critical role in fetal growth and neurocognitive development, necessitating precise interpretation of maternal thyroid function tests, which differ from non-pregnant states. Proper management of thyroid dysfunction can significantly reduce morbidity in both mothers and their fetuses.This review explores the physiological changes in thyroid function during pregnancy, the epidemiology of thyroid disorders, and current guidelines for diagnosis and management. Pregnancy induces anatomical and physiological changes in the thyroid gland, including an increase in gland size and alterations in hormone levels influenced by factors such as hCG and estrogen. These changes necessitate trimester-specific reference ranges for thyroid function tests, as the American Thyroid Association and the American College of Obstetricians and Gynecologists recommended. Hyperthyroidism, primarily caused by Graves' disease and gestational transient thyrotoxicosis, can lead to complications like preeclampsia, preterm birth, and fetal hyperthyroidism. Management includes antithyroid drugs, with careful monitoring to balance maternal and fetal risks. Hypothyroidism, including subclinical and overt forms, is predominantly due to autoimmune thyroiditis and poses risks such as spontaneous abortion, preterm delivery, and impaired neurodevelopment in offspring. The review discusses the debated benefits of levothyroxine treatment for subclinical hypothyroidism, highlighting the need for further research to establish clear guidelines.Given the complex interplay between thyroid function and pregnancy outcomes, this comprehensive review underscores the importance of tailored, evidence-based approaches to managing thyroid disorders in pregnant women.

Keywords: Pregnancy; Thyroid dysfunction.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: No applicable. Competing interests: Anirudha Das is an Associate Editor of Maternal Health, Neonatology and Perinatology. All decisions on this manuscript were made by another senior editor. The authors declare that they have no other competing interests.

Figures

Fig. 1
Fig. 1
A hypothetical representation of thyroid function in pregnancy
See this image and copyright information in PMC

References

    1. Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C, Grobman WA, Laurberg P, Lazarus JH, Mandel SJ, Peeters RP, Sullivan S. 2017 guidelines of the American thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the Postpartum. Thyroid. 2017;27(3):315–89. - PubMed
    1. Robert CS 1, Glinoer D, Hollowell JG, Brent G. Thyroid Function Inside and Outside of Pregnancy: What Do We Know and What Don’t We Know? Thyroid. 2005;15(1):54– 9. - PubMed
    1. Brigitte K, Budenhofer N, Ditsch U, Jeschke R, Ga¨rtner B, Toth. Thyroid (dys-)function in normal and disturbed pregnancy. Arch Gynecol Obstet. 2013;287:1–7. - PubMed
    1. Springer D, Jiskra J, Limanova Z, Zima T, Potlukova E. Thyroid in pregnancy: from physiology to screening. Crit Rev Clin Lab Sci. 2017;54(2):102–16. Epub 2017 Jan 19. PMID: 28102101. - PubMed
    1. Roberto Negro MD, Jorge Hector FACE. Mestman, MD. Thyroid disease in pregnancy. Best Pract Res Clin Endocrinol Metab. 2011;25(6):927–43. - PubMed

LinkOut - more resources