Maternal-Fetal Medicine

Archives of Gynecology and Obstetrics

, Volume 287, Issue 1, pp 1-7

First online:

Thyroid (dys-)function in normal and disturbed pregnancy

  • Brigitte K. BudenhoferAffiliated withDepartment of Obstetrics and Gynecology, Ludwig-Maximilians University
  • , Nina DitschAffiliated withDepartment of Obstetrics and Gynecology, Ludwig-Maximilians University
  • , Udo JeschkeAffiliated withDepartment of Obstetrics and Gynecology, Ludwig-Maximilians University
  • , Roland GärtnerAffiliated withDepartment of Endocrinology, Ludwig-Maximilians University
  • , Bettina TothAffiliated withDepartment of Gynecological Endocrinology and Fertility Disorders, Ruprechts-Karls University Heidelberg Email author 

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During pregnancy, physiologic changes in maternal thyroid function take place especially due to hormonal as well as metabolic processes. Human chorionic gonadotropin activates the maternal thyroid gland leading to increased thyroid hormone production. A sufficient availability of maternal thyroid hormones is essential for fetal development, especially during the first trimester of pregnancy, when the fetal thyroid gland is not yet functional.

Materials and Methods

Current knowledge of thyroid dysfunction including thyroid autoimmunity, hypothyroidism or hyperthyroidism is summarized with special focus on miscarriage and pregnancy disorders. Therefore, a Medline research as well as an analysis of current guidelines on thyroid function and pregnancy was performed.


A study focusing on TSH levels in normal and disturbed pregnancies, the risk of miscarriage in association with thyroid autoantibodies, and (subclinical) hypothyroidism in infertile and fertile women were included.


Maternal thyroid dysfunction negatively affects pregnancy outcome. Besides a routine iodine supplementation in pregnant women and treatment of hypo as well as hyperthyroidism, TSH levels should routinely be measured in women during childbearing years and adjusted to concentrations <2.5 mIU/l in order to optimize maternal health and fetal development.


Pregnancy Miscarriage Thyroid dysfunction Hypothyroidism Hyperthyroidism Thyroid autoimmunity Hashimoto’s thyroiditis