2014 European thyroid association guidelines for the management of subclinical hypothyroidism in pregnancy and in children

2.50
Hdl Handle:
http://hdl.handle.net/11287/593820
Title:
2014 European thyroid association guidelines for the management of subclinical hypothyroidism in pregnancy and in children
Authors:
Lazarus, J.; Brown, R. S.; Daumerie, C.; Hubalewska-Dydejczyk, A.; Negro, R.; Vaidya, Bijay
Abstract:
This guideline has been produced as the official statement of the European Thyroid Association guideline committee. Subclinical hypothyroidism (SCH) in pregnancy is defined as a thyroid-stimulating hormone (TSH) level above the pregnancy-related reference range with a normal serum thyroxine concentration. Isolated hypothyroxinaemia (defined as a thyroxine level below the 2.5th centile of the pregnancy-related reference range with a normal TSH level) is also recognized in pregnancy. In the majority of SCH the cause is autoimmune thyroiditis but may also be due to iodine deficiency. The cause of isolated hypothyroxinaemia is usually not apparent, but iodine deficiency may be a factor. SCH and isolated hypothyroxinaemia are both associated with adverse obstetric outcomes. Levothyroxine therapy may ameliorate some of these with SCH but not in isolated hypothyroxinaemia. SCH and isolated hypothyroxinaemia are both associated with neuro-intellectual impairment of the child, but there is no evidence that maternal levothyroxine therapy improves this outcome. Targeted antenatal screening for thyroid function will miss a substantial percentage of women with thyroid dysfunction. In children SCH (serum TSH concentration >5.5-10 mU/l) normalizes in >70% and persists in the majority of the remaining patients over the subsequent 5 years, but rarely worsens. There is a lack of studies examining the impact of SCH on the neuropsychological development of children under the age of 3 years. In older children, the evidence for an association between SCH and impaired neuropsychological development is inconsistent. Good quality studies examining the effect of treatment of SCH in children are lacking.
Citation:
Eur Thyroid J. 2014 Jun;3(2):76-94.
Publisher:
Karger
Journal:
European thyroid journal
Issue Date:
1-Jun-2014
URI:
http://hdl.handle.net/11287/593820
DOI:
10.1159/000362597
PubMed ID:
25114871
Additional Links:
http://www.karger.com/?DOI=10.1159/000362597
Note:
This article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.
Type:
Journal Article
Language:
eng
ISSN:
2235-0640
Appears in Collections:
2014 RD&E publications; Diabetes/Endocrine Services

Full metadata record

DC FieldValue Language
dc.contributor.authorLazarus, J.en
dc.contributor.authorBrown, R. S.en
dc.contributor.authorDaumerie, C.en
dc.contributor.authorHubalewska-Dydejczyk, A.en
dc.contributor.authorNegro, R.en
dc.contributor.authorVaidya, Bijayen
dc.date.accessioned2016-01-19T12:35:21Zen
dc.date.available2016-01-19T12:35:21Zen
dc.date.issued2014-06-01en
dc.identifier.citationEur Thyroid J. 2014 Jun;3(2):76-94.en
dc.identifier.issn2235-0640en
dc.identifier.pmid25114871en
dc.identifier.doi10.1159/000362597en
dc.identifier.urihttp://hdl.handle.net/11287/593820en
dc.description.abstractThis guideline has been produced as the official statement of the European Thyroid Association guideline committee. Subclinical hypothyroidism (SCH) in pregnancy is defined as a thyroid-stimulating hormone (TSH) level above the pregnancy-related reference range with a normal serum thyroxine concentration. Isolated hypothyroxinaemia (defined as a thyroxine level below the 2.5th centile of the pregnancy-related reference range with a normal TSH level) is also recognized in pregnancy. In the majority of SCH the cause is autoimmune thyroiditis but may also be due to iodine deficiency. The cause of isolated hypothyroxinaemia is usually not apparent, but iodine deficiency may be a factor. SCH and isolated hypothyroxinaemia are both associated with adverse obstetric outcomes. Levothyroxine therapy may ameliorate some of these with SCH but not in isolated hypothyroxinaemia. SCH and isolated hypothyroxinaemia are both associated with neuro-intellectual impairment of the child, but there is no evidence that maternal levothyroxine therapy improves this outcome. Targeted antenatal screening for thyroid function will miss a substantial percentage of women with thyroid dysfunction. In children SCH (serum TSH concentration >5.5-10 mU/l) normalizes in >70% and persists in the majority of the remaining patients over the subsequent 5 years, but rarely worsens. There is a lack of studies examining the impact of SCH on the neuropsychological development of children under the age of 3 years. In older children, the evidence for an association between SCH and impaired neuropsychological development is inconsistent. Good quality studies examining the effect of treatment of SCH in children are lacking.en
dc.language.isoengen
dc.publisherKargeren
dc.relation.urlhttp://www.karger.com/?DOI=10.1159/000362597en
dc.title2014 European thyroid association guidelines for the management of subclinical hypothyroidism in pregnancy and in childrenen
dc.typeJournal Articleen
dc.identifier.journalEuropean thyroid journalen
dc.description.noteThis article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.en

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