Part 1: What You Should Know About Hypothyroidism and Pregnancy

HRPC staff looking at ultrasound picture on computer

Understanding the symptoms is your first defense against complications

Do you know if you have hypothyroidism? Do you know the risks associated with it if you are pregnant? If you have never had symptoms of low thyroid output, your doctor may not test you for the condition when you become pregnant. Routine screening for hypothyroidism is still debated by medical experts. However, the experts do agree that the risk for complications is real if you should go into a pregnancy with hypothyroidism or develop it after you conceive. These risks include:
        • miscarriage
        • gestational hypertension or preeclampsia
        • maternal anemia
        • preterm delivery (before 32 weeks)
        • stillbirth
        • placental abnormalities
        • low birth weight
        • increased rate of cesarean section
        • post partum hemorrhage
        • impaired cognitive development in infants
        • poor breastfeeding
Hypothyroidism occurs when the thyroid gland can’t make as much thyroid hormone as the body needs to function properly. The thyroid gland is generally thought to control your metabolism but has other critical functions as well.  An estimated 3 to 10 percent of women suffer from hypothyroidism and a minimum of 12,000 to 16,000 babies are born each year to mothers whose condition was not detected or treated.

Why you need adequate levels of thyroid

Thyroid hormone is critical for the normal brain development of your baby and for your own continued health. In hypothyroidism, the thyroid gland does not produce enough thyroid to regulate the body’s metabolism, causing all the body’s organ functions to slow down.

Why we check for hypothyroidism in pregnant women

As high-risk pregnancy specialists, we are vigilant about discussing hypothyroidism with our patients and looking for symptoms such as fatigue, intolerance to the cold, dry skin, depression, constipation and un-characteristic weight gain that may indicate a low thyroid balance. We urge all women who want to conceive or are already pregnant to talk with your primary care doctors or obstetricians about the disease and report any changes in your health, even if you believe they are insignificant. It is especially critical to let your doctor know if you have dealt with any of the following:
  • prior treatment for hyperthyroidism
  • the autoimmune disease Hashimoto’s thyroiditis
  • iodine deficiency
  • a removed thyroid gland
  • diabetes
  • infertility
  • a family history of thyroid disease or goiter
  • previous head or neck radiation treatment
  • a damaged pituitary gland
  • a history of thyroiditis—an inflammation of the thyroid gland—usually caused by a viral infection or autoimmune attack.
It is not uncommon to have hypothyroidism and experience no symptoms at all. It is also not uncommon to believe the symptoms you are having are normal conditions of pregnancy. Unfortunately, the result of not having universal testing is that many women experience risks such as miscarriages and preterm labor without ever knowing that the cause was low thyroid. If you’ve had unexplained problems with a previous pregnancy, a thyroid test can eliminate low thyroid as a future problem. Having as much information as you can about this condition is an important step toward a healthier pregnancy. Read Part 2 of this article to learn about the treatment of hypothyroidism in pregnant women.