title: Screening for thyroid disorders during pregnancy: results of a survey in Maine.
abstract: OBJECTIVE
  Guidelines regarding prenatal screening for thyroid deficiency are conflicting, and current practice in primary care settings is unknown. Our survey sought to determine the: 1) extent of screening in Maine; 2) factors associated with screening; and 3) laboratory cut-off levels used.
  
  
  METHODS
  In 2004 we surveyed 61 prenatal care practices, representing 246 practitioners and 85% of Maine deliveries.
  
  
  RESULTS
  Screening via thyroid-stimulating hormone (TSH) testing was routine in 48% of the practices. Obstetrician practices screened at a significantly higher rate than family practices (56% vs 8%; odds ratio [OR] 15.0, 95% CI 1.9-130.0). Nonsignificant higher rates were found for urban versus rural, and multipractitioner versus solo practices. The lower TSH cut-off levels ranged between 0.1 and 0.5 mU/L among practices; the upper cut-off levels ranged between 3.5 and 5.5 mU/L.
  
  
  CONCLUSIONS
  Prenatal screening for thyroid deficiency varies among practices, reflecting conflicting guidelines. TSH cut-offs are also variable and might benefit from standardization.
authors.affiliation: Foundation for Blood Research, Scarborough, ME, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Haddow
authors.forename: Monica R
authors.initials: MR
authors.lastname: McClain
authors.forename: Glenn E
authors.initials: GE
authors.lastname: Palomaki
authors.forename: Edward M
authors.initials: EM
authors.lastname: Kloza
authors.forename: Josephine
authors.initials: J
authors.lastname: Williams
mesh_terms: D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008281:Maine; D008403:Mass Screening / Q000706:statistics & numerical data*; D009774:Obstetrics / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011295:Prenatal Care / Q000706:statistics & numerical data*; D012016:Reference Values; D013959:Thyroid Diseases / Q000175:diagnosis*; D013972:Thyrotropin / Q000097:blood
chemical_list: D013972:Thyrotropin