Screening for thyroid disorders during pregnancy: results of a survey in Maine.
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.
Haddow
James E
JE
Foundation for Blood Research, Scarborough, ME, USA.
McClain
Monica R
MR
Palomaki
Glenn E
GE
Kloza
Edward M
EM
Williams
Josephine
J
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
D013972:Thyrotropin