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Berta Soldevila Department of Endocrinology & Nutrition. Germans Trias i Pujol University Hospital, Badalona, Spain
Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
Department of Medicine, Autonomous University of Barcelona, Badalona, Spain

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Inés Velasco Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
Department of Obstetrics & Gynecology, Germans Trias i Pujol University Hospital, Badalona, Spain

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Carla Muñoz Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain

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Yesika Díaz Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
Health Department, Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, Badalona, Spain

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Laia Egea-Cortés Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
Health Department, Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, Badalona, Spain

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Laura Ferrer-Escopiñan Department of Endocrinology & Nutrition. Germans Trias i Pujol University Hospital, Badalona, Spain
Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain

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Alejandra Pérez-Montes de Oca Department of Endocrinology & Nutrition. Germans Trias i Pujol University Hospital, Badalona, Spain
Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain

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Raquel Martínez-Mondejar Department of Obstetrics & Gynecology, Germans Trias i Pujol University Hospital, Badalona, Spain

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Jordi Casabona Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
Health Department, Centre d’Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Generalitat de Catalunya, Badalona, Spain

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Manel Puig-Domingo Department of Endocrinology & Nutrition. Germans Trias i Pujol University Hospital, Badalona, Spain
Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
Department of Medicine, Autonomous University of Barcelona, Badalona, Spain

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outcomes, such as an increased risk of miscarriages, prematurity, preeclampsia, or alterations in fetal neurodevelopment ( 2 , 3 , 4 ). On the other hand, during pregnancy, physiological changes occur in the thyroid gland that modulate the maternal

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Laura Croce Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy
Istituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Pavia (PV), Italy

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Fausta Beneventi Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia (PV), Italy

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Federica Ripepi Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy

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Irene De Maggio Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia (PV), Italy

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Alberto Malovini Istituti Clinici Scientifici Maugeri IRCCS, Laboratory of Informatics and Systems Engineering for Clinical Research, Pavia (PV), Italy

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Camilla Bellingeri Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia (PV), Italy

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Francesca Coperchini Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy

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Marsida Teliti Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy
Istituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Pavia (PV), Italy

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Mario Rotondi Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy
Istituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Pavia (PV), Italy

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Arsenio Spinillo Department of Obstetrics and Gynecology, IRCCS Foundation Policlinico San Matteo, University of Pavia, Pavia (PV), Italy

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Flavia Magri Department of Internal Medicine and Therapeutics, University of Pavia, Pavia (PV), Italy
Istituti Clinici Scientifici Maugeri IRCCS, Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Pavia (PV), Italy

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Introduction Subclinical thyroid dysfunction during pregnancy is a frequent condition. The latest American Thyroid Association (ATA) guidelines on thyroid dysfunction during pregnancy revised the TSH serum threshold for the diagnosis of

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Stine Linding Andersen Departments of Endocrinology, Aalborg, Denmark
Departments of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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Peter Laurberg Departments of Endocrinology, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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[ 2 ], and this may well lead to inadequate iodine intake among pregnant women because there is an increase in the need for iodine during pregnancy [ 3 , 4 ]. Thus, in recent years there has been much focus on the potential need for individual intake

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Peter Taylor Departments of Diabetes and Endocrinology, Royal United Hospital, Bath
Centre for Endocrine and Diabetes Sciences, Department of Medicine, Cardiff University School of Medicine, Cardiff, UK

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Sandip Bhatt Departments of Gastroenterology, Royal United Hospital, Bath

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Ravi Gouni Departments of Diabetes and Endocrinology, Royal United Hospital, Bath

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Jonathan Quinlan Departments of Gastroenterology, Royal United Hospital, Bath

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Tony Robinson Departments of Diabetes and Endocrinology, Royal United Hospital, Bath

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What Is Known about This Topic • The prevalence of hyperthyroidism in pregnancy has been estimated to range between 0.1 and 1% [ 1 , 2 , 3 , 4 , 5 ] and if untreated or poorly treated there is an increased risk of adverse outcomes including

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Suvi Turunen Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland

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Marja Vääräsmäki Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland

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Maarit Leinonen Information Services Department, Finnish Institute of Health and Welfare, Helsinki, Finland

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Mika Gissler Information Services Department, Finnish Institute of Health and Welfare, Helsinki, Finland
Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden

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Tuija Männistö Northern Finland Laboratory Centre Nordlab, Oulu, Department of Neurobiology, Care Sciences and Society, Finland Karolinska Institute, Stockholm, Sweden

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Eila Suvanto Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland

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Introduction Thyroid dysfunction affects up to 5–7% of all pregnancies [ 1 ]. Hypothyroidism in pregnant women is common with a prevalence of about 2-3%, and the prevalence of undiagnosed subclinical hypothyroidism in pregnancy is 3–15% [ 2

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Lise Husted Department of Clinical Biochemistry, Viborg Regional Hospital, Viborg, Denmark

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Sidsel Rødgaard-Hansen Department of Clinical Biochemistry, Viborg Regional Hospital, Viborg, Denmark

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Maja Hjelm Lundgaard Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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Nanna Maria Uldall Torp Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Stine Linding Andersen Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Introduction A normal pregnancy entails physiological alterations to ensure maternal and fetal health. The adaptations are profound and affect nearly every organ system including maternal thyroid and renal function ( 1 ). The high levels of

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Kris Poppe Endocrine Unit, Department of Internal Medicine, University Hospital UZ Brussel (VUB), Brussels, Belgium

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Alicja Hubalewska-Dydejczyk Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland

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Peter Laurberg Department of Endocrinology and Medicine, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark

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Roberto Negro Division of Endocrinology, V. Fazzi Hospital, Lecce

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Francesco Vermiglio Cattedra di Endocrinologia, Policlinico Universitario, Messina, Italy

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Bijay Vaidya Department of Endocrinology, Royal Devon & Exeter Hospital, Exeter, UK

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Introduction The prevalence of hyperthyroidism in pregnancy ranges between 0.1 and 1% [ 1 ]. The most common cause of hyperthyroidism in pregnancy is Graves’ disease (GD), occurring in about 85% of cases. Gestational transient thyrotoxicosis

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Roberto Negro Division of Endocrinology, “V. Fazzi” Hospital, Lecce, Italy

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Roberto Attanasio Endocrinology Service, Galeazzi Institute IRCCS, Milan, Italy

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Enrico Papini Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy

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Rinaldo Guglielmi Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy

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Franco Grimaldi Endocrinology and Metabolic Disease Unit, Azienda Ospedaliero-Universitaria “S. Maria della Misericordia”, Udine, Italy

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Vincenzo Toscano Endocrinology, Department of Clinical and Molecular Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Roma, Italy

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Dan Alexandru  Niculescu Department of Endocrinology, Carol Davila University of Medicine of Pharmacy, Bucharest, Romania

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Diana Loreta  Paun Department of Endocrinology, Carol Davila University of Medicine of Pharmacy, Bucharest, Romania

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Catalina Poiana Department of Endocrinology, Carol Davila University of Medicine of Pharmacy, Bucharest, Romania

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Introduction An increasing number of studies focusing on thyroid disease and pregnancy have been published over the last decades. Such interest has been driven by at least 2 factors: the relevant number of women suffering from thyroid disease

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John Lazarus Thyroid Research Group, Institute of Molecular Medicine, Cardiff University, University Hospital of Wales, Cardiff

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Rosalind S. Brown Clinical Trials Research Division of Endocrinology, Children's Hospital Boston, Harvard Medical School, Boston, Mass., USA

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Chantal Daumerie Endocrinologie, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium

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Alicja Hubalewska-Dydejczyk Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland

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Roberto Negro Division of Endocrinology, V. Fazzi Hospital, Lecce, Italy

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Bijay Vaidya Department of Endocrinology, Royal Devon and Exeter Hospital and University of Exeter Medical School, Exeter, UK

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Introduction Subclinical hypothyroidism (SCH) in pregnancy is defined by a serum thyroid-stimulating hormone (TSH) concentration higher than the upper limit of the pregnancy-related reference range associated with a normal serum thyroxine [T 4

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Stine Linding Andersen Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Niels Henrik Bruun Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark

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Peter Astrup Christensen Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Simon Lykkeboe Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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Aase Handberg Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Annebirthe Bo Hansen Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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Maja Hjelm Lundgaard Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

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Louise Knøsgaard Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Nanna Maria Uldall Torp Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

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Allan Carlé Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark

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Jesper Karmisholt Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark

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Inge Bülow Pedersen Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark

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Peter Vestergaard Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark

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Stig Andersen Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Department of Geriatrics, Aalborg University Hospital, Aalborg, Denmark

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thyroglobulin antibodies (Tg-Ab) are the hallmarks of autoimmune hypothyroidism ( 3 ). Hypothyroidism is a concern in women who become pregnant, because of the association with adverse outcomes of pregnancy and child development ( 4 , 5 ). The adverse effects

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