Brazil updates thyroid treatment guidelines for pregnant women

The Brazilian Society of Endocrinology and Metabology (SBEM) and the Brazilian Federation of Gynecology and Obstetrics (Febrasgo) have updated medical guidelines regarding thyroid treatment during pregnancy. Under the new recommendations, pregnant women who test positive for anti-TPO antibodies but maintain normal thyroid function (normal T4 levels) should no longer receive preventive synthetic hormone treatment, such as levothyroxine.

The decision follows three major studies demonstrating that preventive hormone treatment in these specific cases does not reduce the risks of miscarriage or premature birth. The new Brazilian guidelines align with recent updates from the American Thyroid Association.

While preventive medication is no longer recommended for those with normal thyroid function despite positive antibodies, medical professionals will continue to monitor thyroid activity closely. This is due to a documented increased risk of developing hypothyroidism during pregnancy. Unlike the American approach, which suggests selective screening based on risk factors, Brazil intends to maintain early screening for all pregnant women to ensure no abnormalities are overlooked.