2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum

Erik K. Alexander, Elizabeth N. Pearce, Gregory A. Brent, Rosalind S. Brown, Herbert Chen, Chrysoula Dosiou, William A. Grobman, Peter Laurberg, John H. Lazarus, Susan J. Mandel, Robin P. Peeters, Scott Sullivan

Research output: Contribution to journalArticle

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Abstract

Background: Thyroid disease in pregnancy is a common clinical problem. Since the guidelines for the management of these disorders by the American Thyroid Association (ATA) were first published in 2011, significant clinical and scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid disease in women during pregnancy, preconception, and the postpartum period. Methods: The specific clinical questions addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of task force members. Task force panel members were educated on knowledge synthesis methods, including electronic database searching, review and selection of relevant citations, and critical appraisal of selected studies. Published English language articles were eligible for inclusion. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations. The guideline task force had complete editorial independence from the ATA. Competing interests of guideline task force members were regularly updated, managed, and communicated to the ATA and task force members. Results: The revised guidelines for the management of thyroid disease in pregnancy include recommendations regarding the interpretation of thyroid function tests in pregnancy, iodine nutrition, thyroid autoantibodies and pregnancy complications, thyroid considerations in infertile women, hypothyroidism in pregnancy, thyrotoxicosis in pregnancy, thyroid nodules and cancer in pregnant women, fetal and neonatal considerations, thyroid disease and lactation, screening for thyroid dysfunction in pregnancy, and directions for future research. Conclusions: We have developed evidence-based recommendations to inform clinical decision-making in the management of thyroid disease in pregnant and postpartum women. While all care must be individualized, such recommendations provide, in our opinion, optimal care paradigms for patients with these disorders.

Original languageEnglish
Pages (from-to)315-389
Number of pages75
JournalThyroid
Volume27
Issue number3
DOIs
StatePublished - Mar 1 2017

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Thyroid Diseases
Postpartum Period
Pregnancy
Advisory Committees
Thyroid Gland
Pregnant Women
Prenatal Nutritional Physiological Phenomena
Thyroid Function Tests
Thyroid Nodule
Thyrotoxicosis
Pregnancy Complications
Health Policy
Hypothyroidism
Administrative Personnel
Thyroid Neoplasms
Lactation
Iodine
Autoantibodies
Decision Making
Physicians

Keywords

  • postpartum thyroiditis
  • Pregnancy
  • thyroid and pregnancy
  • thyroid function tests

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Alexander, E. K., Pearce, E. N., Brent, G. A., Brown, R. S., Chen, H., Dosiou, C., ... Sullivan, S. (2017). 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum. Thyroid, 27(3), 315-389. DOI: 10.1089/thy.2016.0457

2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum. / Alexander, Erik K.; Pearce, Elizabeth N.; Brent, Gregory A.; Brown, Rosalind S.; Chen, Herbert; Dosiou, Chrysoula; Grobman, William A.; Laurberg, Peter; Lazarus, John H.; Mandel, Susan J.; Peeters, Robin P.; Sullivan, Scott.

In: Thyroid, Vol. 27, No. 3, 01.03.2017, p. 315-389.

Research output: Contribution to journalArticle

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, '2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum' Thyroid, vol 27, no. 3, pp. 315-389. DOI: 10.1089/thy.2016.0457
Alexander EK, Pearce EN, Brent GA, Brown RS, Chen H, Dosiou C et al. 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum. Thyroid. 2017 Mar 1;27(3):315-389. Available from, DOI: 10.1089/thy.2016.0457

Alexander, Erik K.; Pearce, Elizabeth N.; Brent, Gregory A.; Brown, Rosalind S.; Chen, Herbert; Dosiou, Chrysoula; Grobman, William A.; Laurberg, Peter; Lazarus, John H.; Mandel, Susan J.; Peeters, Robin P.; Sullivan, Scott / 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum.

In: Thyroid, Vol. 27, No. 3, 01.03.2017, p. 315-389.

Research output: Contribution to journalArticle

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abstract = "Background: Thyroid disease in pregnancy is a common clinical problem. Since the guidelines for the management of these disorders by the American Thyroid Association (ATA) were first published in 2011, significant clinical and scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid disease in women during pregnancy, preconception, and the postpartum period. Methods: The specific clinical questions addressed in these guidelines were based on prior versions of the guidelines, stakeholder input, and input of task force members. Task force panel members were educated on knowledge synthesis methods, including electronic database searching, review and selection of relevant citations, and critical appraisal of selected studies. Published English language articles were eligible for inclusion. The American College of Physicians Guideline Grading System was used for critical appraisal of evidence and grading strength of recommendations. The guideline task force had complete editorial independence from the ATA. Competing interests of guideline task force members were regularly updated, managed, and communicated to the ATA and task force members. Results: The revised guidelines for the management of thyroid disease in pregnancy include recommendations regarding the interpretation of thyroid function tests in pregnancy, iodine nutrition, thyroid autoantibodies and pregnancy complications, thyroid considerations in infertile women, hypothyroidism in pregnancy, thyrotoxicosis in pregnancy, thyroid nodules and cancer in pregnant women, fetal and neonatal considerations, thyroid disease and lactation, screening for thyroid dysfunction in pregnancy, and directions for future research. Conclusions: We have developed evidence-based recommendations to inform clinical decision-making in the management of thyroid disease in pregnant and postpartum women. While all care must be individualized, such recommendations provide, in our opinion, optimal care paradigms for patients with these disorders.",
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