VALÈNCIA – Managing diabetes and thyroid function during pregnancy is crucial for both maternal and infant health, according to specialists. Endocrine disorders are among the most common medical complications encountered during pregnancy, with diabetes (both pre-existing and gestational) and thyroid issues significantly impacting the well-being of mother, and child. Early diagnosis and specialized monitoring are key to ensuring a safe pregnancy and minimizing potential complications.
The complexities of pregnancy demand significant hormonal and metabolic adjustments. According to Dr. Darío Lara Gálvez, an endocrinologist and nutritionist at Hospital Vithas Valencia 9 de Octubre, “Pregnancy is a stage that requires a great endocrine and metabolic adaptation. When alterations such as diabetes or thyroid problems exist, it is essential to anticipate with good planning or detect them in time during gestation.” Effective management of these conditions requires a proactive approach, even before conception.
Planning for Women with Pre-existing Conditions
Clinical guidelines recommend that women with pre-existing diabetes or diagnosed hypothyroidism plan their pregnancies and attend a preconception consultation. “Adequate control before conception significantly reduces the risk of miscarriage, congenital malformations, and maternal complications during pregnancy,” explains Dr. Lara. This proactive step allows for optimization of health parameters before the added physiological demands of pregnancy begin.
Screening During Pregnancy
Even in women without prior diagnoses, pregnancy itself can trigger endocrine alterations. Systematic screening strategies for gestational diabetes are employed, typically involving an oral glucose tolerance test between weeks 24 and 28. Early detection and management can prevent complications such as macrosomia (large birth weight), cesarean deliveries, neonatal hypoglycemia, and an increased long-term risk of diabetes for the mother.
To monitor thyroid dysfunction, Spanish scientific societies (SEEN and SEGO) recommend universal screening for TSH and free T4 between weeks 9 and 11 of gestation. This early screening aims to detect hypothyroidism or hyperthyroidism promptly, ensuring proper neurological development of the fetus.
Endocrine Disorders and Cardiovascular Risk in Pregnancy
The presence of diabetes or thyroid dysfunction during pregnancy doesn’t only affect fetal development; it’s also linked to a higher risk of cardiovascular and obstetric complications, including gestational hypertension and preeclampsia. “In the case of gestational and pre-existing diabetes,” Dr. Lara states, “it has been shown to increase the incidence of preeclampsia, preterm birth, and hypertensive complications, especially when coexisting with obesity. These women also have a higher long-term risk of developing type 2 diabetes and cardiovascular disease.”
Untreated clinical or subclinical hypothyroidism has been associated with recurrent miscarriages, preterm birth, and intrauterine fetal death, as well as an increased risk of preeclampsia and hypertensive complications. Hyperthyroidism during gestation, though less common, is also linked to a higher risk of preterm birth, low birth weight, and maternal cardiovascular complications, highlighting the importance of early detection and treatment.
As Dr. Lara emphasizes, “Pregnancy constitutes a real stress test for the maternal organism. Diabetes and thyroid dysfunction are two alterations that, if not detected and controlled, significantly increase the risk of cardiovascular and obstetric complications, putting both the mother’s and the fetus’s health at risk.”
Effective coordination between endocrinologists and obstetricians is essential. “With early diagnosis and appropriate treatment, most women with diabetes or thyroid disorders can have a normal pregnancy and delivery, with healthy babies,” Dr. Lara concludes. This collaborative approach ensures comprehensive care throughout the pregnancy journey.
Disclaimer: This article provides general information and should not be considered medical advice. Always consult with a qualified healthcare professional for personalized guidance regarding your health and pregnancy.
The next step for expectant mothers is to discuss their individual risk factors and screening options with their healthcare provider. Share this information with your network and continue the conversation about proactive prenatal care.
