Postpartum Follow-Up of Women Who Developed Subclinical Hypothyroidism during Pregnancy

Medical Sciences

Ioannis Ilias¹  Eftychia Koukkou¹  Aikaterini Michou¹  Anastasia Linardi¹  Athina Pappa¹  Ioannis Kakoulidis¹  Evangelia Venaki¹ 

[1] Department of Endocrinology, Diabetes and Metabolism, Elena Venizelou General and Maternity Hospital, 11521 Athens, Greece;

关键词: subclinical hypothyroidism;    pregnancy;    postpartum;    lactation;    levothyroxine;   

DOI  :  10.3390/medsci8030029

来源: DOAJ

【 摘 要 】

There is inconsistency in the literature regarding the management of women diagnosed with subclinical hypothyroidism (SCH) during pregnancy in the postpartum period. The purpose of our study was to assess the need for continuation of levothyroxine (LT4) treatment after delivery. We conducted a retrospective cohort study of 114 women with new-onset SCH during pregnancy and at 1-year follow-up postpartum. Criteria for continuation of LT4 after delivery were breastfeeding, thyrotropin (TSH) levels at diagnosis >5 mIU/L, positive antithyroid antibodies and LT4 dose before delivery >50 μg/day. On treatment initiation, mean TSH ± SD was 5.24 ± 2.55 mIU/L. One year after delivery, most patients (86/114) were still on LT4. This was related to TSH levels at the initiation of treatment in gestation (p = 0.004) and inversely related to primiparity (p = 0.019). In the group of patients who stopped LT4 postpartum, treatment was reinstated in 11 out of 39 (28.2%) due to SCH relapse (mean TSH ± SD = 9.09 ± 5.81 mIU/L). Most women in our study continued treatment after delivery, and a considerable number of women who had discontinued LT4 restarted treatment postpartum. These results stress the need to reassess thyroid function at 6 to 12 months postpartum.

【 授权许可】

Unknown