![]() Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Interestingly, treatment with LT4 prior to conception did not significantly alter the rates of live births, pregnancy loss, preterm birth, or neonatal outcomes in a study of 952 euthyroid women with positive anti-TPO antibodies. ![]() These women also had lower rates of premature delivery, comparable to rates in women without thyroid antibodies. Additionally, Negro et al showed that euthyroid Caucasian women with positive anti−thyroid peroxidase (anti-TPO) antibodies who were treated with LT4 during the first trimester had lower miscarriage rates than those who were not treated. ![]() In a meta-analysis of 19 prospective cohort studies (47,045 women), the risk of preterm birth was higher in association with subclinical hypothyroidism, isolated hypothyroxinemia (decreased free T4 concentration with normal TSH concentration), and thyroid peroxidase antibody positivity. ![]() Autoimmune thyroid disease without overt hypothyroidism has been associated with adverse pregnancy outcomes, as has subclinical hypothyroidism. ![]()
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