The Thyroid and Pregnancy

Abstract

Pregnancy results in physiological changes that affect thyroid function. The management of thyroid disease in a pregnant woman sets particular challenges because diagnosis, treatment and follow-up can vary from that for a nonpregnant patient. It is very important that these patients are cared for correctly right from the start of pregnancy, because the development of the foetus may otherwise be negatively affected. This applies not least to the central nervous system.

During pregnancy, there is an immunosuppression with a reduction of helper T cells (CD4) and an increase in the number of suppressor T cells (CD8). These changes relate to the lowered rejection tendency following the course of pregnancy. At the same time, lowered activity is noted in immune-mediated diseases such as rheumatoid arthritis, myasthenia gravis and thyroid diseases such as Graves’ disease. Autoimmune diseases often arise after parturition or existing conditions can be reactivated with a transient or long-term period of increased disease activity following pregnancy.