Clinical studies at home and abroad have proven that different types of hypothyroidism in pregnant women can cause a significant increase in miscarriage and pregnancy complications, and more importantly, hypothyroidism in pregnant women can cause brain development disorders in the fetus, resulting in a 10-point drop in IQ of the offspring. Experts point out that women of childbearing age with hypothyroidism should be treated to make their thyroid function reach the standard before conceiving and raising the next generation; women with hypothyroidism during pregnancy should be treated with drug intervention as early as possible, during which thyroid function needs to be closely monitored and drug dose adjusted in time to reach the standard as early as possible to ensure normal intellectual development of the offspring. 1.What is hypothyroidism in pregnancy? Hypothyroidism in pregnancy refers to a woman’s hypothyroidism during pregnancy, i.e. the body’s thyroid gland cannot secrete enough thyroxine to meet the needs of the mother and child’s body. Positive thyroid antibodies and reduced FT4 levels are also considered. 2.What are the symptoms of hypothyroidism in pregnancy? The symptoms of hypothyroidism in pregnancy include: loss of energy, lethargy, weight gain, fear of cold, constipation and memory loss. Among them, mild hypothyroidism only has mild clinical symptoms, and these symptoms are easily confused with pregnancy reactions and can be easily ignored. At present, China does not routinely screen pregnant women for thyroid function, so the diagnosis rate of hypothyroidism in pregnancy is very low. 3. Why does hypothyroidism in pregnancy lead to a decrease in fetal intelligence? The fetus needs thyroid hormones for brain development. During the first 12 weeks of pregnancy, the fetus is in the first rapid development period of brain development, but at this time, the fetus’ own thyroid function has not yet been established, and the thyroid hormone needed for fetal brain development is completely dependent on the mother’s supply. If the mother-to-be suffers from hypothyroidism or subclinical hypothyroidism during this period, i.e. the mother’s thyroid hormone level is continuously low and cannot provide sufficient thyroid hormone for fetal brain development, it will affect fetal brain development and even cause irreversible damage. 4.How to avoid the harm of hypothyroidism in pregnancy to the fetus? Early screening: Women of childbearing age should go to the endocrinology department or related departments of regular hospitals to have their thyroid function tested in the first trimester of pregnancy or at the same time when pregnancy is confirmed. Usually, the doctor will draw a certain amount of venous blood from the subject for the test, and the results will be available the same day or the next day. Early treatment: Treatment of hypothyroidism in pregnancy is simple and effective. Supplementation with adequate amounts of exogenous thyroxine (such as oral levothyroxine sodium tablets) throughout pregnancy and lactation is effective in preventing a decline in fetal intelligence. For iodine deficiency, supplementation with adequate amounts of iodine can achieve the same effect. 5. At present, thyroid screening has not been included in the routine screening program of pregnancy tests in China. If a pregnant woman wants to have a thyroid screening, should she go to the obstetrics or endocrinology department? A pregnant woman’s thyroid screening should first be explained to her obstetrician to request the test. If a pregnant woman has a serious condition, the obstetrician should consult and treat her in conjunction with an endocrinologist. It is better if there is a thyroid specialist or a thyroid gynecologist. 6.What week of pregnancy should I have my thyroid checked? Can thyroid checkups be performed in all hospitals? No, thyroid screening is available throughout pregnancy, preferably before the 12th week of pregnancy. Not all hospitals are consciously carrying out this test because of the low level of thyroid knowledge among our population. However, hospitals in general are equipped for the test. 7.What should I do if I am diagnosed with hypothyroidism? If you have been diagnosed with hypothyroidism before you get pregnant: it is best to take medication to control your serum TSH below 2.5mIU/L before you consider getting pregnant. After a successful pregnancy, individualized dose adjustment is also required under the guidance of your doctor. Typically, the requirement for levothyroxine increases by 30% to 300% after pregnancy compared to pre-pregnancy. If hypothyroidism is diagnosed after pregnancy: medication should be administered immediately and serum TSH should be controlled as soon as possible within 12 weeks of pregnancy at 0.001 – 1.0 mIU/L and later at 0.3 – 2.0. The earlier the TSH standard is reached, the less the effect of hypothyroidism in pregnancy on fetal brain development will be. 8. Is subclinical hypothyroidism in pregnancy more harmful than hypothyroidism? The meaning of subclinical hypothyroidism in pregnancy: A, elevated TSH level (>2.5), otherwise normal; B, reduced level of free thyroxine (FT4) alone, also called hypothyroxemia; C, positive thyroid antibodies (TgAb, TPOAb). These three can be present alone, together, or in different combinations, but in any case, one of them is the disease and must be treated. Timely detection and treatment of subclinical hypothyroidism in pregnancy can prevent not only obstetric complications such as miscarriage, preterm labor, abortion, stillbirth, hemorrhage, but also fetal malformations! And it can improve the offspring’s IQ and motor scores by 10 points each! In other words, the offspring will have 10 points higher IQ and 10 points higher motor score, otherwise, of course, 10 points lower! There is no essential difference between gestational hypothyroidism and subclinical hypothyroidism in pregnancy, the latter is an early stage of the former, and the former is a bit more severe. But the latter is more common, generally 5 – 10 times more common than the former. The former is treated with a slightly larger amount of medication, the latter may also be compared to the former’s medication, generally a little smaller.