title: [Detection of thyroid dysfunction in pregnant women: universal screening is justified].
abstract: There is a controversy among different scientific societies in relation to the recommendations on whether universal screening for the detection of thyroid dysfunction during gestation should be performed or not. Although various studies have shown an association between subclinical hypothyroidism or hypothyroxinemia with obstetric problems and/or neurocognitive impairment in the offspring, no evidence on the possible positive effects of treatment of such conditions with thyroxin has been demonstrated so far. However, there is a general agreement about the need for treatment of clinical hypothyroidism during pregnancy and the risks of not doing so. Because it is a common, easily diagnosed and effectively treated disorder without special risk, the working Group of Iodine Deficiency Disorders and Thyroid Dysfunction of the Spanish Society of Endocrinology and Nutrition and Spanish Society of Gynaecology and Obstetrics recommends an early evaluation (before week 10) of thyroid function in all pregnant women. Given the complex physiology of thyroid function during pregnancy, hormone assessment should be performed according to reference values for each gestational trimester and generated locally in each reference laboratory. Thyrotropin determination would be sufficient for screening purposes and only if it is altered, free thyroxin or total thyroxin would be required. Adequate iodine nutrition is also highly recommended before and during pregnancy to contribute to a normal thyroid function in the pregnant women and fetus.
authors.affiliation: Servicio de Endocrinología y Nutrición, Hospital de Sant Joan Despí Moisès Broggi (SEEN), Sant Joan Despí, Barcelona, España. lluis.vila@sanitatintegral.org
authors.forename: Lluís
authors.initials: L
authors.lastname: Vila
authors.forename: Inés
authors.initials: I
authors.lastname: Velasco
authors.forename: Stella
authors.initials: S
authors.lastname: González
authors.forename: Francisco
authors.initials: F
authors.lastname: Morales
authors.forename: Emilia
authors.initials: E
authors.lastname: Sánchez
authors.forename: José Maria
authors.initials: JM
authors.lastname: Lailla
authors.forename: Txanton
authors.initials: T
authors.lastname: Martinez-Astorquiza
authors.forename: Manel
authors.initials: M
authors.lastname: Puig-Domingo
mesh_terms: D015415:Biomarkers / Q000097:blood; D004032:Diet; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D007037:Hypothyroidism / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control; D007455:Iodine / Q000627:therapeutic use; D008403:Mass Screening; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control; D011295:Prenatal Care; D039401:Prenatal Nutritional Physiological Phenomena; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use; D014131:Trace Elements / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; D014131:Trace Elements; D013972:Thyrotropin; D007455:Iodine; D013974:Thyroxine