Patient education about subclinical hypothyroidism in preconception and early pregnancy

Introduction: The diagnosis and treatment of Subclinical Hypothyroidism (SCH) in preconception and early pregnancy has been an area of debate. The challenge of managing SCH further lies in often suboptimal patient understanding of the condition given its asymptomatic state. This study aimed to assess whether patient education materials could improve patient knowledge about SCH and encourage compliance with clinical management. Furthermore, we reviewed the current recommendations for the diagnosis and treatment of SCH in preconception and pregnancy. Methods: Patients who presented to the Reproductive Medicine and Infertility Clinic, Augusta University, Georgia, USA between July 2023 and February 2024, who were attempting to conceive or in early pregnancy, and who met the SCH diagnostic criteria were invited to participate in this prospective cohort study. The study participants completed a pre-education and demographic questionnaire, underwent a brief consultation with a provider who reviewed the SCH information sheet, and then completed the post-education questions. Paired Wilcoxon rank-sum tests of significance were used to evaluate the change in pre- and post-education scores. Results: Thirteen patients completed the survey. There was a range of pre-existing knowledge about SCH in our study population. Most patients acquired knowledge about SCH diagnosis (Q1: P = 0.013) during the counseling. Patient education improved their attitudes about the treatment of SCH with levothyroxine (Q3: P = 0.029). Conclusion: While the clinical guidelines on diagnosis and treatment of SCH in preconception and early pregnancy continue to evolve as more research becomes available, patient education can significantly improve their knowledge about the condition and encourage compliance with treatment if indicated.