Keywords
Natural history
Hypothyroidism
Thyrotoxicosis
Thyroid diseases
Thyroid Gland
How to Cite
Abstract
Background: Postpartum thyroiditis is an autoimmune condition that typically occurs within a year following childbirth, including instance following a miscarriage.
Purpose: To elucidate the natural history of postpartum thyroiditis to enhance its management in both primary and specialized care settings.
Methodology: A narrative review was conducted on studies pertaining to postpartum thyroiditis and its natural course. Articles published in English and Spanish within the last 20 years up to January 2023, were considered for inclusion.
Results: The review encompasses 33 studies focusing on the natural history of postpartum thyroiditis. While the condition has been observed in women without a history of thyroid disorders, it has also been reported in individuals with pre-existing hypothyroidism or Hashimoto's thyroiditis. The natural progression of postpartum thyroiditis involves distinct phases, with a noteworthy transient thyrotoxicosis phase that may resolve spontaneously or transition to a hypothyroid state before returning to a euthyroid state within the first year. Additionally, a smaller subset of cases may present with a solitary hypothyroid phase that also resolves without intervention. The likelihood of progressing to permanent hypothyroidism (after the first postpartum year) is influenced by various factors, including levels of thyroid-stimulating hormone, antithyroid peroxidase antibodies, multiparity, maternal age, among others.
Conclusions: Postpartum thyroiditis represents a prevalent autoimmune disorder triggered withing the first year following childbirth. Its clinical course typically involves multiple phases, underscoring the importance of ongoing thyroid function assessments beyond the initial year to determine the necessity for continued thyroid hormone replacement therapy. Notably, there is a high recurrence rate of the condition in subsequent pregnancies.
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