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Maternal Thyroid Disease and Preterm Delivery

Touro University College of Medicine, Hackensack, New Jersey 07601

Address all correspondence and requests for reprints to: Alex Stagnaro-Green, M.D., M.H.P.E., Touro University College of Medicine, Senior Associate Dean for Academic Affairs, Chairman-Academy of Medical Educators, 19 Main Street, Hackensack, New Jersey 07601. E mail: alex.stagnaro-green{at}touro.edu.

Context: Preterm delivery is the leading cause of perinatal morbidity and mortality in the United States, and its incidence is increasing. The present manuscript reviews the literature on the relationship of hypothyroidism and/or autoimmune thyroid disease to preterm delivery.

Evidence Acquisition: A PubMed search was used to identify all relevant articles. A reference search of all retrieved articles was undertaken. All articles identified in the search were included in the review.

Evidence Synthesis: Uncontrolled case series were discussed in the manuscript but not included in drawing conclusions from the literature.

Conclusions: Hypothyroidism and autoimmune thyroid disease in euthyroid women are associated with preterm delivery. A single intervention trial has documented a dramatic decrease in the incidence of preterm delivery in thyroid antibody-positive women treated with levothyroxine. Confirmatory studies are needed before universal screening and intervention can be recommended.