Graves' disease and pregnancy

Ann Endocrinol (Paris). 2018 Dec;79(6):636-646. doi: 10.1016/j.ando.2018.08.004. Epub 2018 Aug 16.

Abstract

This section deals with the specificities of managing Graves' disease during pregnancy. Graves' disease incurs risks of fetal, neonatal and maternal complications that are rare but may be severe: fetal hyper- or hypothyroidism, usually first showing as fetal goiter, neonatal dysthyroidism, premature birth and pre-eclampsia. Treatment during pregnancy is based on antithyroid drugs alone, without association to levothyroxine. An history of Graves' disease, whether treated radically or not, with persistent maternal anti-TSH-receptor antibodies must be well identified. Fetal monitoring should be initiated in a multidisciplinary framework that should be continued throughout pregnancy. Neonatal monitoring is also crucial if the mother still shows anti-TSH-receptor antibodies at end of pregnancy or underwent antithyroid treatment. The risk of recurrence of hyperthyroidism in the weeks following delivery requires maternal monitoring. The long-term neuropsychological progression of children of mothers with Graves' disease is poorly known.

Keywords: Fetal ultrasound; Graves’ disease; Maladie de Basedow; Multidisciplinarity; Multidisciplinarité; Neonatal monitoring; Surveillance néonatale; TRAB; Teratogenicity; Tératogénicité; Échographie fœtale.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Disease Progression
  • Early Diagnosis
  • Female
  • Graves Disease / blood
  • Graves Disease / congenital
  • Graves Disease / diagnosis
  • Graves Disease / therapy*
  • Humans
  • Infant Care / methods
  • Infant Care / standards
  • Infant, Newborn
  • Infant, Newborn, Diseases / diagnosis
  • Infant, Newborn, Diseases / therapy
  • Neonatal Screening / methods
  • Neonatal Screening / standards
  • Pregnancy
  • Pregnancy Complications / blood
  • Pregnancy Complications / therapy*
  • Prenatal Care / methods
  • Prenatal Care / standards