5th April 2024

Hypothyroidism in pregnancy

Risks associated with untreated hypothyroidism in pregnancy include the following:

• Increased risk of miscarriage
• Anaemia
• Pre-eclampsia
• Placental abruption
• Postpartum haemorrhage
• Stillbirth

Adverse neonatal outcomes include: preterm delivery, low birthweight, neonatal respiratory distress, congenital abnormalities, congenital hypothyroidism and impaired foetal neurocognitive development.

Management is with levothyroxine by maintaining maternal free thyroxine levels in the upper third of normal reference ranges. Thyroxine is safe in pregnancy and breastfeeding. TSH should be checked 4-6 weeks postpartum.