Meet gestational endocrinology expert, Dr Tim Korevaar

Dr Tim Korevaar, Postdoctoral Research Fellow at the Erasmus University Medical Centre in Rotterdam, carries out research on gestational endocrinology, mainly focussing on gestational thyroid disease and diabetes. He will be giving his talk “Maternal thyroid hormone and child brain development” during e-ECE 2020 on Wednesday 9 September at 09:00hrs CET. Read this interview to find out more about his career and what he will be presenting.

Please tell us a little about your career path and current research?

I went to medical school at the Erasmus University Medical Center in Rotterdam. During my studies, I did a 7-month research internship at the University of Oxford with Niki Karavitaki and Ashley Grossman – this was my first encounter with research and fuelled my passion for endocrinology. I then did my PhD at Erasmus on thyroid disease in pregnancy, with Robin Peeters and the late Theo Visser. At the same time, I also obtained a Master’s in Clinical Epidemiology, which allowed me to perform studies that aimed to translate the complex thyroid physiology of pregnancy, into clinical associations and their impact on clinical interpretations and risks. I then spent six months at the Harvard School of Public Health with Russ Hauser, to focus on thyroid and fertility and thyroid disruptors. 

After that, I started my residency at the Erasmus University Medical Centre in Rotterdam. Here, I was able to take over the day-to-day supervision of the thyroid and pregnancy research line and, together with Robin Peeters, we moved the work from my PhD forward. My current research focuses on gestational endocrinology, with a main focus on gestational thyroid disease and diabetes. Clinically, I aim to specialise in endocrine disorders of pregnancy and I am starting a fellowship in Obstetric Medicine at King’s College, London, with Catherine Nelson-Piercy and Catherine Williamson, in September 2020.

What you are most proud of during your career?

What I am most proud of is that I coordinated the setup of the Consortium on Thyroid and Pregnancy. This is a large international collaboration that currently consists of more than 25 studies, which share their individual participant data to do large meta-analyses on the consequences of thyroid disease during pregnancy.

How has the COVID-19 pandemic affected your research?

My research was indirectly affected by the pandemic because I belonged to the workforce on the quarantine wards in my local teaching hospital. The closing of research facilities, as well as the shift in priorities for me and my collaborators in clinical practice definitely delayed some projects. But what I will remember most, is the perseverance of my research collaborators to keep our work going and to make up for the lost time.

What are you presenting at e-ECE 2020?

I am presenting on the importance of maternal thyroid hormone availability for foetal neurodevelopment. I am specifically discussing how we quantify this using human data, and what the pitfalls of the currently available evidence are, such as the available insights from randomised trials.

Is there anything you are particularly looking forward to at this year’s Congress?

The guideline session on pituitary dysfunction during pregnancy, the Meet The Expert session on the future of continuous glucose monitoring and the endocrine disruptor symposium, are on the top of my list. 

What do you think are the biggest challenges in your research area right now?

One of the main challenges is to fill clinical knowledge gaps with high-quality evidence. There simply are not enough resources to perform large randomised trials for all relevant clinical questions. Therefore, the design and relevance of every randomised trial needs to be of the highest possible quality. This can be achieved by prioritizing clinical knowledge gaps, performing smaller observational studies on the underlying physiology or expected effects and, most importantly, by peer-reviewing. This can only be accomplished through international collaboration.

What do you think will be the next major breakthrough in your field?

There are a few things that could have a direct impact on clinical practice. For example, women with mild gestational thyroid function test abnormalities probably cannot be considered as a homogeneous group. Identification of subgroups with different clinical characteristics and risks, will be pivotal in optimising treatment indications. Furthermore, there can be large discrepancies between maternal and foetal thyroid hormone availability, for example during anti-thyroid drug treatment for women with Graves’ disease, or in congenital hypothyroidism. Identification of a marker, or foetal thyroid hormone availability, could provide the means to optimise treatment for both the mother and the foetus.

What do you enjoy most about your work?

Learning new things and continuously being inspired by the people around me.

Who do you admire most professionally?

I admire any medical professional that pushes him or herself to keep learning and question the established body of knowledge in order to improve his/her patient care. I also have a weak spot for Elon Musk.

You can hear Dr Koreevar’s presentation, “Maternal thyroid hormone and child brain development” on Wednesday 9 September at 09:00hrs CET. Find out more about e-ECE 2020 and register today.

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