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Sophie Demartin Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium

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Stefan Matei Constantinescu Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium

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Kris G Poppe Endocrine Unit, Centre Hospitalier Universitaire Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute, Brussels, Belgium

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Dominique Maiter Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium

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Raluca Maria Furnica Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium

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Orsalia Alexopoulou Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium

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Chantal Daumerie Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium

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Frederic Debiève Department of Obstetrics, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium

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Maria-Cristina Burlacu Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium

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Introduction Hypothyroidism diagnosed during pregnancy, whether subclinial or overt, is associated with adverse pregnancy and neonatal outcomes ( 1 ). Existing guidelines unanimously recommend the treatment of overt hypothyroidism (OH) in this

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Heleen I Jansen Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands

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Antonius E van Herwaarden Radboud University Medical Center, Department of Laboratory Medicine, Nijmegen, The Netherlands

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Henk J Huijgen Department of Clinical Chemistry, Red Cross Hospital, Beverwijk, The Netherlands

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Rebecca C Painter Department of Obstetrics and Gynaecology, Amsterdam UMC Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands

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Jacquelien J Hillebrand Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands

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Anita Boelen Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands

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Annemieke C Heijboer Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands

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pregnancy, since the fetus does not produce thyroid hormone itself until 16–20 weeks ( 7 ). Untreated maternal hyperthyroidism can not only have fetal consequences such as intra-uterine growth restriction but also life-threatening maternal consequences as

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Emna Jelloul Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute, Brussels, Belgium

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Georgiana Sitoris Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute, Brussels, Belgium

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Flora Veltri Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute, Brussels, Belgium

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Pierre Kleynen Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute, Brussels, Belgium

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Serge Rozenberg Departement of Gynecology and Obstetrics, Centre Hospitalier Universitaire Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute, Brussels, Belgium

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Kris G Poppe Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute, Brussels, Belgium

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Introduction The guidelines on the management of thyroid disorders in pregnancy (ATA-GL), mention the following: ‘it is important to note that subclinical hyperthyroidism (SH) has not been associated with adverse pregnancy outcomes. Therefore

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Georgiana Sitoris Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Flora Veltri Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Pierre Kleynen Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Malika Ichiche Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Serge Rozenberg Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire (CHU) Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Kris G Poppe Endocrine Unit Centre Hospitalier Universitaire (CHU) Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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), nutritional factors (iodine and iron), high estradiol levels (ovarian stimulation), high hCG levels (twin pregnancies, during gestational weeks 9–13) and, finally, the variability in the TSH assays ( 1 , 2 , 3 , 4 , 5 , 6 ). In a number of studies, the

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

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Annebirthe Bo Hansen Department of Clinical Biochemistry, 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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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 The diagnosis and treatment of thyroid disease during pregnancy are debated and uncertainties exist regarding the assessment of maternal thyroid function in early pregnancy ( 1 , 2 ). During a normal pregnancy, several

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Jan Jiskra 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic

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Jiří Horáček 4th Department of Medicine, Faculty of Medicine, Charles University, University Hospital Hradec Králové, Czech Republic

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Sylvie Špitálníková Department of Nuclear Medicine, District Hospital, Havlíčkův Brod, Czech Republic

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Jan Paleček 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic

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Zdeňka Límanová 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic

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Jan Krátký 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic

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Drahomíra Springer Department of Clinical Biochemistry and Laboratory Diagnostics, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic

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Kristýna Žabková 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic

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Hana Vítková 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic

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Introduction While the prevalence of thyroid nodules during pregnancy in areas with mild to moderate iodine deficiency varies between 3 and 21% ( 1 , 2 ) and increases with increasing parity ( 3 ), data from areas with sufficient iodine

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Georgiana Sitoris Endocrine Unit Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Flora Veltri Endocrine Unit Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Malika Ichiche Endocrine Unit Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Pierre Kleynen Endocrine Unit Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Jean-Philippe Praet Department of Internal Medicine, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Serge Rozenberg Department of Gynecology and Obstetrics, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Kris G Poppe Endocrine Unit Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Introduction Thyroid autoimmunity (TAI) and (subclinical) hypothyroidism (SCH) have been associated with adverse pregnancy outcomes, such as miscarriage, preterm birth, and gestational diabetes mellitus (GDM) ( 1 ). TAI and GDM have been

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Victor J M Pop Department of Medical Psychology, Tilburg University, The Netherlands

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Johannes G Krabbe Department of Clinical Chemistry and Laboratory Medicine, Medisch Spectrum Twente, Medlon BV, Enschede, The Netherlands

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Maarten Broeren Department of Clinical Chemistry, Maxima Medical Centre, Veldhoven, The Netherlands

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Wilmar Wiersinga Department of Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, The Netherlands

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Margaret P Rayman Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK

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Introduction In recent decades, a new concept has been defined with regard to thyroid hormone (TH) function during early pregnancy: isolated hypothyroxinaemia (IH) ( 1 , 2 ). This refers to the condition of women with low free thyroxin (FT4

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Maria Lopes-Pereira Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
Hospital de Braga, Braga, Portugal

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Anna Quialheiro Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal

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Patrício Costa Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal

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Susana Roque Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal

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Nadine Correia Santos Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
ACMP5 – Associação Centro de Medicina P5 (P5), School of Medicine, University of Minho, Braga, Portugal

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Margarida Correia-Neves Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal

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Ana Goios Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal

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Ivone Carvalho Newborn Screening, Metabolism & Genetics Unit, National Institute of Health Dr Ricardo Jorge, Porto, Portugal

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Tim I M Korevaar Academic Center for Thyroid Diseases, Erasmus MC, Rotterdam, the Netherlands
Department of Internal Medicine, Erasmus MC, Rotterdam, the Netherlands
The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands

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Laura Vilarinho Newborn Screening, Metabolism & Genetics Unit, National Institute of Health Dr Ricardo Jorge, Porto, Portugal

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Joana Almeida Palha Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
ICVS/3B’s, PT Government Associate Laboratory, Braga/Guimarães, Portugal
Clinical Academic Center-Braga (2CA-B), Braga, Portugal

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Introduction Iodine is an essential nutrient required for the biosynthesis of thyroid hormone. Thyroid hormone regulates growth and metabolism and is essential for proper fetal brain- and nervous system development ( 1 ). During pregnancy

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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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