Levothyroxine suppression therapy improves maternal and neonatal outcomes in pregnancy after thyroidectomy for differentiated thyroid carcinoma.

OBJECTIVES

To evaluate the efficacy of levothyroxine (L-T4) suppression therapy in women with a history of differentiated thyroid carcinoma (DTC), focusing on pregnancy outcome after thyroidectomy.

METHODS

This retrospective study included 300 pregnancies in women with previous DTC surgery. Participants were divided into an experimental group (n=187) receiving L-T4 doses adjusted based on thyroid-stimulating hormone (TSH) levels and a control group (n=113) following a fixed low-dose L-T4 regimen. We assessed various outcomes, including biochemical values (TSH dynamics, lipid profile, folic acid [FA] levels), obstetric measures (placental function, pregnancy complications), and neonatal outcomes.

RESULTS

The experimental group showed consistently lower TSH levels throughout pregnancy and experienced fewer pregnancy and neonatal complications compared to the control group (all P<0.05). Additionally, the experimental group demonstrated significant improvements in lipid profiles, FA levels, and placental function(all P<0.05).

CONCLUSIONS

TSH-adjusted L-T4 therapy in pregnant women post-DTC thyroidectomy results in better maternal and neonatal outcomes compared to a fixed low-dose L-T4 regimen. This approach optimizes TSH stability, improves lipid and FA profiles, and enhances placental function, leading to improved overall outcomes for both the mother and child.