Thyroid Disease, Pregnancy, and Selenium Supplementation

• Published in: Current obstetrics and gynecology reports 2021-12, Vol.10 (4), p.115-123
• Main Authors: Savastano, Giovanna, Del Negro, Valentina, Pompeo, Damiana, Sorrenti, Sara, Galoppi, Paola, Brunelli, Roberto, Piccioni, Maria Grazia
• Format: Article
• Language: English
• Subjects: Environmental Exposures and Pregnancy Outcomes (D Cantonwine; Maternal and Child Health; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Oncology; Section Editor; Topical Collection on Environmental Exposures and Pregnancy Outcomes
• ISSN: 2161-3303; 2161-3303
• DOI: 10.1007/s13669-021-00314-3

Purpose of Review Thyroid autoimmune disease is very common in women during their fertile age. From 2 to 17% of pregnant women in the general population have thyroid antibodies. A correct thyroid function has an essential role for fetal development, and maternal complications could occur with impaired thyroid function. This study has the purpose of investigating the possible therapeutic use of selenium supplementation in pregnant women with thyroid autoimmune disease, with a focus on the maternal and fetal outcomes. A review of the literature on Pubmed has been conducted, in order to have a general picture of the current knowledge about pregnancy and autoimmune thyroid disease: outcomes and therapy. Recent Findings The present literature agrees on the several positive roles of selenium in women’s reproductive life. It reduces the oxidative stress on the placenta and facilitates fertility and embryo development; it may reduce the onset of preeclampsia, miscarriage, preterm birth, gestational diabetes, and fetal growth restriction. Also, selenium has a positive effect on the immune system. After delivery, supplementation of selenium could decrease the incidence of postpartum thyroiditis in women with autoimmune disease. At last, the correct fetal neurodevelopment requires adequate levels of selenium in the mother’s plasma. Summary Despite the positive effects of selenium during pregnancy, the evidences about the supplementation of selenium are controversial and current guidelines do not recommend its use in pregnancy. It appears mandatory to design further studies to correctly evaluate whether the selenium levels should be pharmacologically implemented during pregnancy in women with thyroid autoimmune disease.