Maternal and Fetal Thyroid Function

Epstein, Franklin H.; Burrow, Gerard N.; Fisher, Delbert A.; Larsen, P. Reed

doi:10.1056/nejm199410203311608

Cited by 720Thyroid Disorders and TreatmentsBirth, Development, and HealthPregnancy and preeclampsia studies

Maternal and Fetal Thyroid Function

Epstein, Franklin H., Burrow, Gerard N., Fisher, Delbert A., Larsen, P. Reed·1994·New England Journal of Medicine

DOI 10.1056/nejm199410203311608

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Abstract

Conception is followed by a series of hormonal and metabolic changes that involve most maternal endocrine systems. With regard to thyroid metabolism, these include an increase in serum thyroxine-binding globulin and thyroid hormone concentrations, increased renal clearance of iodine, and increased production and turnover of thyroxine (T)1. Fetal and maternal thyroid physiology differ, but the systems interact by means of the placenta and amniotic fluid, which modulate the transfer of iodine and small but important amounts of thyroid hormone from mother to fetus1,2. In this article we shall review recent data and new insights regarding the changes . . .

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Serum TSH levels may be below the nonpregnant reference range in the first half of a normal-term pregnancy, especially in gestational weeks 9-13.
“Serum TSH levels may be below the nonpregnant reference range in the first half of a normal-term pregnancy (435,436), and especially so in gestational weeks 9-13, during which a subset of pregnant women may develop a suppressed serum TSH (437-439).”
From 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis (2016) · cites this paper as [435]

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2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis
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“Serum TSH levels may be below the nonpregnant reference range in the first half of a normal-term pregnancy (435,436), and especially so in gestational weeks 9–13, during which a subset of pregnant women may develop a suppressed serum TSH (437–439).”
Background
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Authors: Epstein, F. H., Burrow, G. N., Fisher, D. A., & Larsen, P. R.
Affiliations: Yale University (US)
Brigham and Women's Hospital (US)
Venue: New England Journal of Medicine
Publisher: Massachusetts Medical Society
Published: 1994-10-20
Volume: 331
Issue: 16
Pages: 1072-1078
ISSN: 0028-4793 (ISSN-L)
1533-4406
DOI: 10.1056/nejm199410203311608
OpenAlex: W2088871053
Cited by: 720
References: 76
Citations by year: 2026: 13 · 2025: 14 · 2024: 21 · 2023: 17 · 2022: 26 · 2021: 21 · 2020: 25 · 2019: 22 · 2018: 25 · 2017: 26 · 2016: 31 · 2015: 22 · 2014: 20 · 2013: 22 · 2012: 22
FWCI: 3.71
Type: journal article
Language: en
Open access: closed
Locations: New England Journal of Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Diabetes and Digestive and Kidney Diseases (R01DK044128, DK36256, DK-44128, R01DK036256)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
Keywords: maternal thyroid function, fetal thyroid function, pregnancy, thyroid hormones, thyroxine-binding globulin, iodine metabolism, amniotic fluid
MeSH terms: Amniotic Fluid, Female, Fetus, Humans, Placenta, Pregnancy, Thyroid Gland, Thyroid Hormones, Thyronines

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Maternal and Fetal Thyroid Function

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