Sage publishes 2026 American Thyroid Association Guidelines on Thyroid Disease in Preconception, Pregnancy, and Postpartum

Thousand Oaks, CA — May 29, 2026 — Sage Publishing, in partnership with the American Thyroid Association (ATA), is pleased to announce the publication of the 2026 ATA Guidelines for Thyroid Disease in Preconception, Pregnancy, and Postpartum in Thyroid®, the flagship journal of the ATA.

Developed by an international, multidisciplinary task force, the updated guidelines reflect significant advances in clinical and scientific evidence since the previous ATA recommendations issued in 2017. Thyroid disease remains one of the most common endocrine disorders affecting women during preconception, pregnancy, and the postpartum period, underscoring the importance of clear, evidence-based clinical guidance.

The guidelines are co-first authored by Dr. Tim I.M. Korevaar and Dr. Angela M. Leung, alongside a global team of experts representing 10 international societies, patient advocacy organizations, and methodological specialists.

Advancing Evidence-Based Care

The 2026 guidelines provide comprehensive, evidence-based recommendations intended to support clinicians, researchers, patients, and policymakers in delivering high-quality care before, during, and after pregnancy. The recommendations were informed by prior ATA guidelines and extensive stakeholder feedback, a global needs assessment, and systematic literature reviews conducted with the support of a medical librarian. Evidence was rigorously evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework, with careful consideration given to the quality of evidence, the balance of benefits and harms, patient values, feasibility, and equity. In areas where evidence remains limited, expert-informed Good Practice Statements are included to guide care.

Comprehensive Scope Across the Reproductive Timeline

The updated guidelines provide detailed recommendations spanning key areas of thyroid care, including thyroid function testing, iodine supplementation, and the management of thyroid autoimmunity, hypothyroidism, hypothyroxinemia, hyperthyroidism and Graves’ disease, thyroid nodules and cancer, and postpartum thyroid dysfunction. These recommendations are tailored across the reproductive continuum, addressing the needs of women with infertility, those who are pregnant, and individuals in the postpartum and lactation periods. The guidelines are presented using structured recommendation tables, complemented by practical guidance highlights and detailed supporting information to facilitate clinical implementation.

Supporting Clinical Decision-Making in a Complex Evidence Landscape

While acknowledging that portions of the available evidence remain of low to moderate quality, the guidelines represent the most current international consensus and best practices in the field. They offer a practical, evidence-based framework to support individualized, patient-centered care while also identifying priority areas for future research.

“Healthy pregnancies begin with informed care. The updated ATA pregnancy guidelines provide evidence-based recommendations to support the evaluation and management of thyroid disease before, during, and after pregnancy. Our goal is to provide clinicians with clear recommendations to optimize maternal thyroid health and improve outcomes for both mothers and their babies.” — M. Regina Castro, MD, ATA President