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Hyperthyroidism and Pregnancy

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The Thyroid and Its Diseases

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Abstract

Pregnancies of mothers with a history of Graves’ hyperthyroidism, previously treated, and those diagnosed at time of pregnancy are at higher risk of maternal and obstetrical complications as compared to a euthyroid population. Preconception patient education and contraception are imperative in women with thyroid disease, during the reproductive age. A medical team including endocrinologists, obstetricians, medical fetal-maternal physicians, anesthesiologists, neonatologist, and pediatric endocrinologists should be available from the time pregnancy is diagnosed. Antithyroid drug (ATD) therapy is the treatment of choice; thyroid surgery is indicated in selective cases. Selection of drug, timing of administration, and close follow-up with proper thyroid tests are essential for a good maternal and fetal outcome. Potential complications of ATD therapy should be considered and discussed with potential parents, as well as the interpretation of serum TRAb titers in detecting and treating thyroid fetal and neonatal disease. Breastfeeding recommendations and postpartum follow-up for a year following delivery is part of the care of a woman with a history of Graves’ hyperthyroidism.

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References

  1. Mutaba Q, Burrow N. Treatment of hyperthyroidism in pregnancy with Propylthiouracil and Methimazole. Obstet Gynecol. 1975;46:282–6.

    Google Scholar 

  2. Patil-Sisodia K, Mestman JH. Graves hyperthyroidism and pregnancy: a clinical update. Endocr Pract. 2010;16:118.

    Article  PubMed  Google Scholar 

  3. Cooper DS, Laurberg P. Hyperthyroidism in pregnancy. Lancet Diabetes Endocrinol. 2013;1:238–47.

    Article  CAS  PubMed  Google Scholar 

  4. Labadzhyan A, Brent G, Hershman JM, Leung AM. Thyrotoxicosis of pregnancy. J Clin Trans Endocrinol. 2014;1:140–4.

    Google Scholar 

  5. Krassas GE, Poppe K, Glineor D. Thyroid function and human reproductive health. Endocr Rev. 2010;31:702.

    Article  CAS  PubMed  Google Scholar 

  6. Mandel SL, Larsen PR, Seely EW, et al. Increased need for thyroxine during pregnancy in women with primary hypothyroidism. N Engl J Med. 1990;323:91.

    Article  CAS  PubMed  Google Scholar 

  7. Yassa L, Marqusee E, Fawcett R, et al. Thyroid hormone early adjustment in pregnancy: the THERAPY trial. J Clin Endocrinol Metab. 2010;95:3234–41.

    Article  CAS  PubMed  Google Scholar 

  8. Haddow JE, Palomaki GE, Allan WC, et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med. 1999;341:549.

    Article  CAS  PubMed  Google Scholar 

  9. Peaceman A. Effect of treatment of maternal subclinical hypothyroidism and hypothyroxinemia on pregnancy outcomes. Am J Obstet Gynecol. 2016;214:S200.

    Article  Google Scholar 

  10. Henrichs J, Bongers-Schokking JJ, Schenk JJ, et al. Maternal thyroid function during early pregnancy and cognitive functioning in early childhood: the generation R study. J Clin Endocrinol Metab. 2010;95:4227.

    Article  CAS  PubMed  Google Scholar 

  11. Abalovich M, Vazquez A, Alcaraz G, et al. Adequate levothyroxine doses for the treatment of hypothyroidism newly discovered during pregnancy. Thyroid. 2013;23:1479.

    Article  CAS  PubMed  Google Scholar 

  12. Laurberg P, Bournaud C, Karmisholt J, Orgiazzi J. Management Graves’ hyperthyroidism in pregnancy: focus on both maternal and foetal thyroid function, and caution against surgical thyroidectomy in pregnancy. Eur J Endocrinol. 2009;160:1–8.

    Article  CAS  PubMed  Google Scholar 

  13. Kautbally S, Alexopoulou O, Daumerie C, et al. Greater efficacy of total thyroidectomy versus radioiodine therapy in hyperthyroidism and thyroid stimulating immunoglobulin levels in patients with Graves’ disease previously treated with antithyroid drugs. Europ Thyrid J. 2012;1:122–8.

    Article  CAS  Google Scholar 

  14. Bisschopp PH, van Trotsenburg AS. Images in clinical medicine. Neonatal thyrotoxicosis. N Engl J Med. 2014;370:1237.

    Article  Google Scholar 

  15. Donnelly MA, Wood C, Casey B, et al. Early severe fetal Graves disease in a mother after thyroid ablation and thyroidectomy. Obstet Gynecol. 2015;125(5):1059–62.

    Article  CAS  PubMed  Google Scholar 

  16. Abeillon-du Payrat J, Chikh K, Bossard N, et al. Predictive values of maternal second-generation thyroid-binding inhibitory immunoglobulin assay for neonatal autoimmune hyperthyroidism. Eur J Endcor. 2014;171:451–60.

    Article  CAS  Google Scholar 

  17. Hyer S, Pratt B, Newbold K, et al. Outcome of pregnancy after exposure to radioiodine in utero. Endocr Pract. 2011;17:1–10.

    Article  Google Scholar 

  18. Sawka AM, Lakra DC, Lea J, et al. A systematic review examining the effects of therapeutic radioactive iodine on ovarian function and future pregnancy in female thyroid cancer survivors. Clin Endocrinol. 2008;69(3):479–92.

    Article  Google Scholar 

  19. Glinoer D. Thyroid hyperfunction in pregnancy. Thyroid. 1998;8:859–64.

    Article  CAS  PubMed  Google Scholar 

  20. Hershman JM. Physiological and pathological aspects of the effect of human chorionic gonadotropin on the thyroid. Best Pract Res Clin Endocrinol Metabol. 2004;18:249–65.

    Article  CAS  Google Scholar 

  21. Huang SA, Dorfman DM, Genest DR, Salvatore D, Larsen PR. Type 3 iodothyronine deiodinase is highly expressed in the human uteroplacental unit and in fetal epithelium. J Clin Endocrinol Metab. 2003;88:1384–8.

    Article  CAS  PubMed  Google Scholar 

  22. Hollowell JG, Haddow JE. The prevalence of iodine deficiency in women of reproductive age in the United States of America. Public Health Nutr. 2007;10:1532.

    Article  PubMed  Google Scholar 

  23. Yarrington DC, Pearce EN. Dietary iodine in pregnancy and postpartum. Clin Obstet Gynecol. 2001;54:459–70.

    Article  Google Scholar 

  24. Li C, Shan Z, Mao J, et al. Assessment of thyroid function during first-trimester pregnancy: what is the rational upper limit of serum TSH during the first trimester in Chinese pregnant women? J Clin Endocrinol Metab. 2014;99(1):73.

    Article  CAS  PubMed  Google Scholar 

  25. Patel J, Landers K, Li H, et al. Delivery of maternal thyroid hormones to the fetus. Trends Endocrinol Metab. 2011;22:164.

    Article  CAS  PubMed  Google Scholar 

  26. Polak M, Van Vliet G. Therapeutic approach of fetal thyroid disorders. Hormone Res Pediatr. 2010;74:1–5.

    Article  CAS  Google Scholar 

  27. Lee RH, Spencer CA, Mestman JH, et al. Free T4 immunoassays are flawed during pregnancy. Am J Obstet Gynecol. 2009;200:260.e1.

    Article  CAS  Google Scholar 

  28. Bliddal S, Feldt-Rasmussen U, Boas M, et al. Gestational age-specific reference ranges from different laboratories misclassify pregnant women’s thyroid status: comparison of two longitudinal prospective cohort studies. Eur J Endocrinol. 2013;170(2):329.

    Article  CAS  PubMed  Google Scholar 

  29. Azizi F, Mehran L, Amouzegar A, et al. Establishment of the trimester-specific reference range for free thyroxine index. Thyroid. 2013;23(3):354.

    Article  CAS  PubMed  Google Scholar 

  30. Kahric-Janicic N, Soldin SJ, Soldin OP, West T, Gu J, Jonklaas J. Tandem mass spectrometry improves the accuracy of free thyroxine measurements during pregnancy. Thyroid. 2007;17:303.

    Article  CAS  PubMed  Google Scholar 

  31. Momotani N, Noh J, Oyanagi H, Ishikawa N, Ito K. Antithyroid drug therapy for Graves’ disease during pregnancy. Optimal regimen for fetal thyroid status. N Engl J Med. 1986;315:24–8.

    Article  CAS  PubMed  Google Scholar 

  32. Casey BM, Dashe JS, Wells CE, et al. Subclinical hyperthyroidism and pregnancy outcomes. Obstet Gynecol. 2006;107:337–41.

    Article  PubMed  Google Scholar 

  33. McLachlan SM, Rapoport B. Thyrotropin-blocking autoantibodies and thyroid stimulating Autoantibodies: potential mechanisms involved in the pendulum swinging form hypothyroidism to hyperthyroidism or vice versa. Thyroid. 2013;23:14–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Barbesibo G, Tomer Y. Clinica utility of TSH Receptor antibodies. J Clin Endoc Metabl. 2013;98:2247–013.

    Article  CAS  Google Scholar 

  35. Brown RS, Bellasario RL, Botero D, et al. Incidence of transient congenital hypothyroidism due to maternal thyrotropin antibodies in over one million babies. J Clin Endocrinol Metab. 1996;81:1147.

    CAS  PubMed  Google Scholar 

  36. Contempre B, Jauniaux E, Calvo R, et al. Detection of thyroid hormones inhuman embryonic cavities during the first trimester of pregnancy. J Clin Endocrinol Metab. 1993;77:1719.

    CAS  PubMed  Google Scholar 

  37. Iskaros J, Pickard M, Evans I, et al. Thyroid hormone receptor gene expression in first trimester human fetus brain. J Clin Endocrinol Metab. 2000;85:2620.

    Article  CAS  PubMed  Google Scholar 

  38. Polak M, Le Gac I, Vuillard E, et al. Fetal and neonatal thyroid function in relation to maternal Graves’ disease. Best Prac Res Clin Endocrinol Metab. 2004;18:289–302.

    Article  CAS  Google Scholar 

  39. Polak M, Luton D. Fetla thyroidology. Best practice and research. Clin Endocrinol Metabol. 2014;28:164–73.

    Google Scholar 

  40. Weetman AP. Immunity, thyroid function and pregnancy: molecular mechanisms. Nat Rev Endocrinol. 2010;6(6):311.

    Article  CAS  PubMed  Google Scholar 

  41. Abeillon-du PJ, Chikh K, Bossard N, et al. Predictive value of maternal second generation thyroid-binding inhibitory immunoglobulin assay for neonatal autoimmune hyperthyroidism. Eur J Endocrinol. 2014;171(4):451–60.

    Article  CAS  Google Scholar 

  42. Goldman AM, Mestman JH. Transient non-autoimmune hyperthyroidism of early pregnancy. J Thyroid Res. 2011;2011:142413.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Goodwin TM, Hershman JM. Hyperthyroidism due to inappropriate production of human chorionic gonadotropin. Clin Obstet Gynecol. 1997;40:32–44.

    Article  CAS  PubMed  Google Scholar 

  44. Goodwin TM, Montoro M, Mestman JH. Transient hyperthyroidism and hyperemesis gravidarum: clinical aspects. Am J Obstet Gynecol. 1992;167(3):648L.

    Article  Google Scholar 

  45. Fiaschi Nelson-Piercy C, Tata LJ. Hospital admission for hyperemesis gravidarum: a nationwide study of occurrence, reoccurrence and risk factors among 8.2 million pregnancies. Hum Reprod. 2016;31:1675–84.

    Article  PubMed  Google Scholar 

  46. Coulon AL, Savagner F, Briet C, et al. Prolonged and severe gestational thyrotoxicosis due to enhance hCG sensitivity to a mutant thyrotropin receptor. J Clin Endo Metab. 2016;101:10–1.

    Article  CAS  Google Scholar 

  47. Tamaki H, Itoh E, Kaneda T, et al. Crucial role of serum human chorionic gonadotropin for the aggravation of thyrotoxicosis in early pregnancy in Graves’ disease. Thyroid. 1993;3:189.

    Article  CAS  PubMed  Google Scholar 

  48. Sheffield JS, Cunningham FG. Thyrotoxicosis and heart failure that complicate pregnancy. Am J Obstet Gynecol. 2004;190:211.

    Article  PubMed  Google Scholar 

  49. Easterling TR, Schmucker BC, Carlson KL, Millard SP, Benedetti TJ. Maternal hemodynamics in pregnancies complicated by hyperthyroidism. Obstet Gynecol. 1991;78:348–52.

    CAS  PubMed  Google Scholar 

  50. Mannisto T, Mendola P, Grewal J, Xie Y, Chen Z, Laughon SK. Thyroid diseases and adverse pregnancy outcomes in a contemporary US cohort. J Clin Endocrinol Metab. 2013;98(7):2725.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Clark SL, Phelan JP, Montoro M, Mestman J. Transient ventricular dysfunction associated with cesarean section in a patient with hyperthyroidism. Am J Obstet Gynecol. 1985;151:384–6.

    Article  CAS  PubMed  Google Scholar 

  52. Millar LK, Wing DA, Leung AS, et al. Low birth weight and preeclampsia in pregnancies complicated by hyperthyroidism. Obstet Gynecol. 1994;84(6):946–9.

    CAS  PubMed  Google Scholar 

  53. Aggarawal N, Suri V, Singla R, Chopra S, Sikka P, Shah VN,·Bhansali A. Pregnancy outcome in hyperthyroidism: a case control study Gynecol Obstet Investig 2014;77:94–99.

    Article  Google Scholar 

  54. Luewan S, Chakkabut P, Tongsong T. Outcomes of pregnancy complicated with hyperthyroidism: a cohort study. Arch Gynecol Obstet. 2011;283(2):243.

    Article  PubMed  Google Scholar 

  55. Mitsuada N, Tamaki H, Amino N, et al. Risk factors for developmental disorders in infants born to women with Graves’ disease. Obstet Gynecol. 1992;80:359–64.

    Google Scholar 

  56. Kempers MJE, van Trotsenburg ASP, van Tijn DA. Disturbance of the fetal thyroid hormone state has long-term consequences for treatment of thyroidal and central congenital hypothyroidism. J Clin Endocriol Metab. 2005;90:4094.

    Article  CAS  Google Scholar 

  57. Kempers MJ, van Trotsenburg AS, van Rijn RR, et al. Loss of integrity of thyroid morphology and function in children born to mothers with inadequately treated Graves’ disease. J Clin Endocrinol Metab. 2007;92:2984.

    Article  CAS  PubMed  Google Scholar 

  58. Papendieck P, Chiesa A, Prieto L, Grufieiro-Papendieck L. Thyroid disorders of neonates born to mothers with Graves’ disease. J Ped Endocr Metab. 2009;22:547.

    Google Scholar 

  59. Bahn RS, Burch HS, Cooper DS, et al. The role of propylthiouracil in the management of Graves’ disease in adults: report of a meeting jointly sponsored by the American Thyroid Association and the Food and Drug Administration. Thyroid. 2009;19:673–4.

    Article  CAS  PubMed  Google Scholar 

  60. Angell T, Lechner MG, Nguyen CT, Salvato VL, Nicoloff JT, LoPresti JS. Clinical features and hospital outcomes in thyroid storm: a retrospective cohort study. J Clin Endoc Metab. 2015;100:451–9.

    Article  CAS  Google Scholar 

  61. Taylor PN, Vaidya B. Side effects of anti-thyroid drugs and their impact on the choice of treatment for thyrotoxicosis in pregnancy. Eur Thyroid J. 2012;1(3):176–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Andersen SL, Olsen J, Laurberg P. Antithyroid drug side effects in the population and in pregnancy. J Clin Endocrinol Metab. 2016;101:1606–14.

    Article  PubMed  Google Scholar 

  63. Mortimer Mortimer RH, Tyack SA, Galligan JP, et al. Graves’ disease in pregnancy: TSH receptor binding inhibiting immunoglobulins and maternal and neonatal thyroid function. Clin Endocrinol. 1990;32:14.

    Article  Google Scholar 

  64. Rubin PC. Current concepts: beta-blockers in pregnancy. NEJM. 1981;305:1323–6.

    Article  CAS  PubMed  Google Scholar 

  65. Sherif IH, Oyan WT, Bosairi S, Carrascal SM. Treatment of hyperthyroidism in pregnancy. Acta Obstet Gynecol Scand. 1991;70:461–3.

    Article  CAS  PubMed  Google Scholar 

  66. Bowman ML, Bergmann M, Smith JF. Intrapartum labetalol for the treatment of maternal and fetal thyrotoxicosis. Thyroid. 1998;8:95–6.

    Article  Google Scholar 

  67. Bruner JP, Landon MB, Gabbe SG. Diabetes mellitusand Graves’ disease in pregnancy complicated by maternalallergies to antithyroid medication. Obstet Gynecol. 1988;72:443–5.

    CAS  PubMed  Google Scholar 

  68. Kuy S, Roman SA, Desai R, Sosa JA. Outcomes following thyroid and parathyroid surgery in pregnant women. Arch Surg. 2009;144(5):399.

    Article  PubMed  Google Scholar 

  69. Sheffield JS, Cunningham FG. Thyrotoxicosis and heart failure that complicate pregnancy. Am J Obstet Gynecol. 2004;190(1):211–7.

    Article  PubMed  Google Scholar 

  70. Burch HB, Wartofsky L. Life-threating thyrotoxicosis. Thyroid storm. Endocrinol Metab Clin North. 1993;22:263–77.

    Article  CAS  Google Scholar 

  71. Akamizu T, Satoh T, Isozaki O, et al. Diagnostic criteria, clinical features, and incidence of thyroid storm based on nationwide surveys. Thyroid. 2012;22:661–79.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Fumarola A, Di Fiore A, Dainelli M, et al. Therapy of hyperthyroidism in pregnancy and breastfeeding. Obstet Gynecol Surv. 2011;66(6):378–85.

    Article  PubMed  Google Scholar 

  73. Milham S, Elledje W. Maternal methimazole and 70.- congenital defects in children. Teratology. 1972;5:125–6.

    Article  Google Scholar 

  74. Cheron RG, Kaplan MM, Larsen PR, et al. Neonatal thyroid function after propylthiouracil therapy for maternal Graves’ disease. N Engl J Med. 1981;304:525.

    Article  CAS  PubMed  Google Scholar 

  75. Clementi M, Di Gianantonio E, Pelo E, Mammi I, Basile RT, Tenconi R. Methimazole embryopathy: Delineation of the phenotype. Am J Med Genet. 1999;83:43–66.

    Article  CAS  PubMed  Google Scholar 

  76. Foulds N, Walpole I, Elmslie F, Manour S. Carbimazole embryopathy: an emerging phenotype. Am J Med Genet. 2005;132A:130–5.

    Article  PubMed  Google Scholar 

  77. Andersen SL, Laurberg P. Antithyroid drugs and congenital heart defects: ventricular septal defect is part of the methimazole/Carbimazole embryopathy. Eur J Endocrinol. 2014;171:C1–3.

    Article  CAS  PubMed  Google Scholar 

  78. Besancon A, Beltrand J, Le Gac I, Luton D, Polak M. Management of neonates born to women with Graves’ disease: a cohort study. Europ J Endocrinol. 2014;170:855:862.

    Article  CAS  Google Scholar 

  79. Andersen SL, Olsen J, Wu CS, Laurberg P. Birth defects after early pregnancy use of antithyroid drugs: a Danish nationwide study. J Clin Endocrinol Metabol. 2013;98:4373–81.

    Article  CAS  Google Scholar 

  80. Yoshihara A, Noh J, Yamaguchi T, Ohye H, Sato S, Sekiya K, Kosuga Y, Suzuki M, Matsumoto M, Kunii Y, Watanabe N, Mukasa K, Ito K, Ito K. Treatment of Graves’ disease with antithyroid drugs in the first trimester of pregnancy and the prevalence of congenital malformation. J Clin Endocrinol Metab. 2012;97:2396–403.

    Article  CAS  PubMed  Google Scholar 

  81. Li H, Zheng J, Luo J, et al. Congenital anomalies in children exposed to antithyroid drugs in-utero: a meta-analysis of cohort studies. PLoS One. 2015;10(5):e01266140.

    Google Scholar 

  82. Ishikawa N. The relationship between neonatal developmental dysplasia of the hip and maternal hyperthyroidism. J Pediatr Orthop. 2008;20:432–4.

    Article  Google Scholar 

  83. Finer LB, Zolna MR. Declines in unintended pregnancy in the United States, 2008-2011. N Engl J Med. 2016;374(9):843–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  84. De Groot L, Abalovich M, Alexander EK, et al. Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2012;97(8):2543–65.

    Article  CAS  PubMed  Google Scholar 

  85. Stagnaro-Green A, Abalovich M, Alexdander E, et al. Guidelines of the American Thyroid Association for the Diagnosis and Management of thyroid disease during pregnancy and postpartum. Thyroid. 2011;21:1081.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Lazarus J, Brown RS, Daumerie C, Hubalewska-Dydejczyk A, Negro R, Vaidya B. 2014 European Thyroid Association Guidelines for the management of subclinical hypothyroidism in pregnancy and in children. Eur Thyroid J. 2014;3:76–94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  87. Laurberg P, Andersen SL. Antithyroid drug use in early pregnancy and birth defects: time windows of relative safety and high risk? Eur J Endocrinol. 2014;171:R13–20.

    Article  CAS  PubMed  Google Scholar 

  88. Korevaar TI, Muetzel R, Medici M, et al. Association of maternal thyroid function during early pregnancy with offspring IQ and brain morphology in childhood: a population-based prospective cohort study. Lancet Diabetes Endocrinol. 2016;4(1):35–43.

    Article  CAS  PubMed  Google Scholar 

  89. Towers CV, Thomas S, Steiger RM. The fetal heart monitor tracing in pregnancies complicate d by fetal thyrotoxicosis. Am J Perinat. 2009;26:373–7.

    Article  Google Scholar 

  90. Luton D, LeGac I, Vuillard E, et al. Management of Graves’ disease during pregnancy: the key role of fetal thyroid gland monitoring. J Clin Endocrinol Metab. 2005;90:6093–8.

    Article  CAS  PubMed  Google Scholar 

  91. Ranzini AC, Ananth CV, Smulian JC, et al. Ultrasonography of the fetal thyroid: nomograms based on biparietal diameter and gestational age. J Ultrasound Med. 2011;20(6):613–7.

    Article  Google Scholar 

  92. Nachum Z, Rakover Y, Weiner E, Shalev E. Graves’ disease in pregnancy: prospective evaluation of a selective invasive treatment protocol. Am J Obstet Gynecol. 2003;189:159–65.

    Article  PubMed  Google Scholar 

  93. Bliddal S, Rasmussen AK, Sundberg K, et al. Antithyroid drug-induced fetal goitrous hypothyroidism. Nat Rev Endocrinol. 2011;7(7):396–406.

    Article  CAS  PubMed  Google Scholar 

  94. Levy-Shraga Y, Tamir-Hostovsky L, Boyko V, et al. Follow-up of newborns of mothers with Graves’ disease. Thyroid. 2014;24(6):1032–9.

    Article  CAS  PubMed  Google Scholar 

  95. Momotani N, Noh J, Ishikawa N, et al. Relationship between silent thyroiditis and recurrent Graves’ disease in the postpartum period. J Clin Endocrinol Metab. 1994;79:285.

    CAS  PubMed  Google Scholar 

  96. Amino N, Tada H, Hidaka Y. Postpartum autoimmune thyroid syndrome: a model of aggravation f autoimmune disease. Thyroid. 1999;9:705–13.

    Article  CAS  PubMed  Google Scholar 

  97. Tada H, Hidaka Y, Tsuruta E, et al. Prevalence of postpartum onset of disease within patients with Graves’ disease of child-bearing age. Endocr J. 1994;41:325–7.

    Article  CAS  PubMed  Google Scholar 

  98. Benhaim Rochester D, Davies TF. Increased risk of Graves’ disease after pregnancy. Thyroid. 2005;15:1287–90.

    Article  PubMed  Google Scholar 

  99. Stagnaro Green A, Schawartz A, Gismondi R, et al. High rate of persistent hypothyroidism in a large-scale prospective study of postpartum thyroiditis in southern Italy. J Clin Endocr Metab. 2011;96:652–7.

    Article  CAS  PubMed  Google Scholar 

  100. Ide A, Amino N, Kang S, et al. Differentiation of postpartum Graves’ thyrotoxicosis from postpartum destructive thyrotoxicosis using antithyrotropin receptor antibodies and thyroid blood flow. Thyroid. 2014;24:1027.

    Article  CAS  PubMed  Google Scholar 

  101. Yoshihara A, Noh JY, Watanabe N, et al. Lower incidence of postpartum thyrotoxicosis in women with Graves disease treated by radioiodine therapy than by subtotal thyroidectomy or with antithyroid drugs. Clin Nucl Med. 2014;39(4):326.

    Article  PubMed  Google Scholar 

  102. Momotani N, Yamashita R, Makino F, Noh JY, Ishikawa N, Ito K. Thyroid function in wholly breast-feeding infants whose mothers take high doses of propylthiouracil. Clin Endocrinol. 2000;53:177–81.

    Article  CAS  Google Scholar 

  103. Azizi F, Khoshniat M, Bahrainian M, Hedayati M. Thyroid function and intellectual development of infants nursed by mothers taking methimazole. J Clin Endocrinol Metab. 2000;85:3233–8.

    Article  CAS  PubMed  Google Scholar 

  104. Karras S, Krassas GE. Breastfeeding and antithyroid drugs: a view from within. Eur Thyroid J. 2012;1(1):30–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  105. Refetoff S, DeWind LT, DeGroot LJ. Familial syndrome combining deaf mutism, stippled epiphyses, goiter and abnormally high PBI: possible target organ refractoriness to thyroid hormone. J Clin Endocrinol Metab. 1967;27:279.

    Article  CAS  PubMed  Google Scholar 

  106. Weiss RE, Dumitrescu A, Refetoff S. Approach to the patient with resistance to thyroid hormone and pregnancy. J Clin Endoc Metab. 2010;95:3094–100.

    Article  CAS  Google Scholar 

  107. Anselmo J, Cao D, Karrison T, et al. Fetal loss associated with excess thyroid hormone exposure. JAMA. 2004;292:691.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Diabetes and Endocrinology, Department of Medicine, Keck USC School of Medicine, University of Southern California, Los Angeles, CA, USA

    Jorge H. Mestman

  2. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Keck USC School of Medicine, University of Southern California, Los Angeles, CA, USA

    Jorge H. Mestman

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  1. Jorge H. Mestman
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Correspondence to Jorge H. Mestman .

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Editors and Affiliations

  1. Department of Nuclear Medicine, Philipps University Marburg, Marburg, Germany

    Markus Luster

  2. Unit of Endocrinology Diabetes and Metabolism, Evgenidion Hospital, National and Kapodistrian University of Athens, Athens, Greece

    Leonidas H. Duntas

  3. Georgetown University School of Medicine, Washington, DC, USA

    Leonard Wartofsky

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Mestman, J.H. (2019). Hyperthyroidism and Pregnancy. In: Luster, M., Duntas, L., Wartofsky, L. (eds) The Thyroid and Its Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-72102-6_48

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