Nieuwe ATA-richtlijn zwangerschap en schildklier
Geplaatst: 09 jan 2017, 15:43
2017 Guidelines of the American Thyroid Association for the
Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum
Met link: http://online.liebertpub.com/doi/pdfplu ... .2016.0457
Authors: Erik K. Alexander MD (co-chairperson), Elizabeth N. Pearce MD,MSc (cochairperson and corresponding author),
Gregory A. Brent MD, Rosalind S. Brown MD, Herbert Chen MD, Chrysoula Dosiou MD, MS, William A. Grobman MD,
Peter Laurberg MD, John H. Lazarus MD, Susan J. Mandel MD, Robin P. Peeters MD, PhD, and Scott Sullivan MD
Abstract
Background: Thyroid disease in pregnancy is a common clinical problem. Since the guidelines
for the management of these disorders by the American Thyroid Association (ATA) were first
published in 2011, significant clinical and scientific advances have occurred in the field. The aim
of these guidelines is to inform clinicians, patients, researchers, and health policy makers on
published evidence relating to the diagnosis and management of thyroid disease in women
during pregnancy, preconception and the postpartum period.
Methods: The specific clinical questions addressed in these guidelines were based on prior
versions of the guidelines, stakeholder input, and input of task force members. Task force panel
members were educated on knowledge synthesis methods, including electronic database
searching, review and selection of relevant citations, and critical appraisal of selected studies.
Published English-language articles were eligible for inclusion. The American College of
Physicians Guideline Grading System was used for critical appraisal of evidence and grading
strength of recommendations. The guideline task force had complete editorial independence from
the ATA. Competing interests of guideline task force members were regularly updated,
managed, and communicated to the ATA and task force members.
Results: The revised guidelines for the management of thyroid disease in pregnancy include
recommendations regarding the interpretation of thyroid function tests in pregnancy, iodine
nutrition, thyroid autoantibodies and pregnancy complications, thyroid considerations in infertile
women, hypothyroidism in pregnancy, thyrotoxicosis in pregnancy, thyroid nodules and cancer
in pregnant women, fetal and neonatal considerations, thyroid disease and lactation, screening
for thyroid dysfunction in pregnancy, and directions for future research.
Conclusions: We have developed evidence-based recommendations to inform clinical decisionmaking
in the management of thyroid disease in pregnant and postpartum women. While all care
must be individualized, such recommendations provide, in our opinion, optimal care paradigms
for patients with these disorders.
Diagnosis and Management of Thyroid Disease during Pregnancy and the Postpartum
Met link: http://online.liebertpub.com/doi/pdfplu ... .2016.0457
Authors: Erik K. Alexander MD (co-chairperson), Elizabeth N. Pearce MD,MSc (cochairperson and corresponding author),
Gregory A. Brent MD, Rosalind S. Brown MD, Herbert Chen MD, Chrysoula Dosiou MD, MS, William A. Grobman MD,
Peter Laurberg MD, John H. Lazarus MD, Susan J. Mandel MD, Robin P. Peeters MD, PhD, and Scott Sullivan MD
Abstract
Background: Thyroid disease in pregnancy is a common clinical problem. Since the guidelines
for the management of these disorders by the American Thyroid Association (ATA) were first
published in 2011, significant clinical and scientific advances have occurred in the field. The aim
of these guidelines is to inform clinicians, patients, researchers, and health policy makers on
published evidence relating to the diagnosis and management of thyroid disease in women
during pregnancy, preconception and the postpartum period.
Methods: The specific clinical questions addressed in these guidelines were based on prior
versions of the guidelines, stakeholder input, and input of task force members. Task force panel
members were educated on knowledge synthesis methods, including electronic database
searching, review and selection of relevant citations, and critical appraisal of selected studies.
Published English-language articles were eligible for inclusion. The American College of
Physicians Guideline Grading System was used for critical appraisal of evidence and grading
strength of recommendations. The guideline task force had complete editorial independence from
the ATA. Competing interests of guideline task force members were regularly updated,
managed, and communicated to the ATA and task force members.
Results: The revised guidelines for the management of thyroid disease in pregnancy include
recommendations regarding the interpretation of thyroid function tests in pregnancy, iodine
nutrition, thyroid autoantibodies and pregnancy complications, thyroid considerations in infertile
women, hypothyroidism in pregnancy, thyrotoxicosis in pregnancy, thyroid nodules and cancer
in pregnant women, fetal and neonatal considerations, thyroid disease and lactation, screening
for thyroid dysfunction in pregnancy, and directions for future research.
Conclusions: We have developed evidence-based recommendations to inform clinical decisionmaking
in the management of thyroid disease in pregnant and postpartum women. While all care
must be individualized, such recommendations provide, in our opinion, optimal care paradigms
for patients with these disorders.