Update on the Risk Factors for Thyroid Dysfunction in Pregnancy

Thyroid disorders are common in pregnancy and if left untreated, they can have serious consequences. There is an ongoing debate as to whether thyroid screening in pregnancy should be universal. Current guidelines recommend a risk-based thyroid screening, which is a health strategy offering TSH measurement to higher-risk women only. Given the key role of risk stratification, in this narrative review, we aimed to (i) describe the established risk factors for thyroid disease in pregnancy; (ii) provide an update on the emerging risk factors; (iii) examine their overall potential utility. For this purpose, a comprehensive literature search was conducted across the PubMed, Scopus, and Web of Science databases, employing a combination of MeSH terms and relevant keywords, including ‘thyroid dysfunction’, ‘pregnancy’, ‘risk factors’, ‘screening’. In conclusion, the current literature confirms that thyroid autoimmunity and moderate-to-severe iodine deficiency remain the most consistent and reproducible predictors of thyroid dysfunction.