University of Rhode Island, Providence, Rhode Island 02881, USA.
J Clin Endocrinol Metab. 2012 Aug;97(8):2543-65. doi: 10.1210/jc.2011-2803.
The aim was to update the guidelines for the management of thyroid dysfunction during pregnancy and postpartum published previously in 2007. A summary of changes between the 2007 and 2012 version is identified in the Supplemental Data (published on The Endocrine Society's Journals Online web site at http://jcem.endojournals.org).
This evidence-based guideline was developed according to the U.S. Preventive Service Task Force, grading items level A, B, C, D, or I, on the basis of the strength of evidence and magnitude of net benefit (benefits minus harms) as well as the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence.
The guideline was developed through a series of e-mails, conference calls, and one face-to-face meeting. An initial draft was prepared by the Task Force, with the help of a medical writer, and reviewed and commented on by members of The Endocrine Society, Asia and Oceania Thyroid Association, and the Latin American Thyroid Society. A second draft was reviewed and approved by The Endocrine Society Council. At each stage of review, the Task Force received written comments and incorporated substantive changes.
Practice guidelines are presented for diagnosis and treatment of patients with thyroid-related medical issues just before and during pregnancy and in the postpartum interval. These include evidence-based approaches to assessing the cause of the condition, treating it, and managing hypothyroidism, hyperthyroidism, gestational hyperthyroidism, thyroid autoimmunity, thyroid tumors, iodine nutrition, postpartum thyroiditis, and screening for thyroid disease. Indications and side effects of therapeutic agents used in treatment are also presented.
更新 2007 年发表的关于妊娠和产后甲状腺功能障碍管理指南。补充资料（发表于内分泌学会期刊在线网站 http://jcem.endojournals.org）中列出了 2007 年和 2012 年版本之间的变化概要。
本循证指南是根据美国预防服务工作组制定的，根据证据强度和净效益（效益减去危害）以及推荐分级评估、制定与评价（GRADE）系统对项目进行分级，A级、B 级、C 级、D 级或 I 级，以描述建议的强度和证据的质量。
指南是通过一系列电子邮件、电话会议和一次面对面会议制定的。工作组在医学作家的协助下编写了初始草案，并由内分泌学会、亚洲和大洋洲甲状腺协会以及拉丁美洲甲状腺学会的成员进行了审查和评论。第二稿由内分泌学会理事会审查和批准。在审查的每个阶段，工作组都收到了书面意见，并进行了实质性的修改。
提出了与妊娠前后及产后甲状腺相关医疗问题患者的诊断和治疗的实践指南。这些包括评估病情原因、治疗和管理甲状腺功能减退症、甲状腺功能亢进症、妊娠性甲状腺功能亢进症、甲状腺自身免疫、甲状腺肿瘤、碘营养、产后甲状腺炎以及筛查甲状腺疾病的循证方法。还介绍了治疗中使用的治疗药物的适应症和副作用。
