Discussion
Thyroid diseases, especially those of autoimmune origin, are common in women of childbearing age. These disorders are significantly influenced not only by avariety of changes in thyroid function that take place during normal gestation but also by the privileged immune state that occurs in pregnancy. Therefore, interpretation of thyroid function tests during gestation requires specific pregnancy ranges that are not widely available. In our opinion, adequate screening programs should be established in order to prevent the consequences of delay in or misdiagnosis of thyroid dysfunction during pregnancy, which can pose potentially significant adverseeffectstobothmotherandchild.Thecorrectapproach to the diagnosis and therapy of thyroid dysfunction in pregnancy requires monthly fetal and maternal monitoring and its continuationintothepostpartumperiodwhentheonsetofthe postpartum thyroid syndromes should be expected.
Disclosure Statement
T.F.D. is a Member of the Board of Kronus Inc., which markets diagnostic kits, including those for thyroid autoantibodies,andisalecturerforAbbottCorp,manufacturersof l-thyroxine.J.C.G.hasreceived travelsupport fromGenzyme Corp., manufacturers of recombinant TSH.