Thyroid disorders are among the most prevalent endocrine conditions affecting women of reproductive age and are associated with significant reproductive, obstetric, and neonatal complications. In 2026, the American Thyroid Association (ATA) published updated evidence-based guidelines for the diagnosis and management of thyroid disease during preconception, pregnancy, and the postpartum period. These guidelines represent a substantial revision of the 2017 recommendations and incorporate emerging evidence regarding gestational thyroid physiology, thyroid function testing, iodine nutrition, thyroid autoimmunity, hypothyroidism, hyperthyroidism, Graves’ disease, thyroid nodules, thyroid cancer, and postpartum thyroid dysfunction. This review critically examines the methodological framework, key recommendations, strengths, limitations, and clinical implications of the updated ATA guidelines. Comparisons with the 2017 guidelines are presented to highlight major changes in clinical practice. The review further discusses future research priorities necessary to strengthen the evidence base for thyroid disease management in reproductive medicine.
Keywords: clinical guidelines, graves’ disease, hyperthyroidism, hypothyroidism, postpartum thyroiditis, preconception, pregnancy, thyroid disease, thyroid function testing
