New guidelines for managing thyroid disease in pregnancy

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Takeaway
  • New guidelines from the American Thyroid Association (ATA) are the first evidence-based guidelines for the management of thyroid disease in pregnancy issued by the ATA since 2011.
Why this matters
  • Thyroid disease during pregnancy is a common problem.
  • Many changes in the field since 2011.
Study design
  • For each existing clinical question, a literature search was performed, literature was reviewed, and recommendations were made and reviewed by the panel.
  • The panel also extended earlier guidelines to include thyroid disease during lactation, and treatment of thyroid disease in infertile women and women using assisted reproductive technology, as well as treating thyroid disease in newborns.
  • Funding: ATA. Task force members have received consulting fees from GmbH and Veracyte, among others.
Key results
  • 24-h urine iodine concentrations are not a valid marker for an individual patient's iodine nutritional status.
  • All pregnant women should consume approximately 250 µg of iodine daily.
  • Women who are pregnant or planning to be should supplement their diet with 150 µg of iodine in the form of potassium iodide.
  • Serum thyroid stimulating hormone assay recommended for all women pursuing infertility care.
  • 97 more recommendations total.
Limitations
  • Small number of high quality trials on thyroid disease in pregnancy.