title: Evaluation of risk-factor-based screening for thyroid peroxidase antibody positivity in pregnancy.
abstract: OBJECTIVE
  To determine whether risk-factor-based screening for thyroid dysfunction in pregnancy performs well for detecting thyroid peroxidase antibodies (TPOAb), a marker for autoimmune thyroid disease.
  
  
  METHODS
  We prospectively evaluated pregnant women for thyroid dysfunction using The Endocrine Society's eleven screening questions. Serum was analysed for TPOAb.
  
  
  RESULTS
  We enrolled 546 women. TPOAb positivity was higher in women with a personal (odds ratio (OR) = 8·0; 95% confidence interval (CI) = 1·7-37·4; P = 0·02) or family history of thyroid disease (OR = 2·7; 95% CI = 1·3-5·7; P = 0·02). There was no association between the number of positive responses and TPOAb positivity (P = 0·41). Risk-factor-based screening missed 18 women (33%) with TPOAb.
  
  
  CONCLUSIONS
  One-third of women with TPOAb were missed by the case-finding method. A personal or family history of thyroid disease was most strongly associated with TPOAb positivity.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Paola
authors.initials: P
authors.lastname: Aghajanian
authors.affiliation: Department of Endocrinology, Keck School of Medicine, University Southern California, Los Angeles, CA, USA.
authors.forename: Carole A
authors.initials: CA
authors.lastname: Spencer
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University Southern California, Los Angeles, CA, USA.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Wilson
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University Southern California, Los Angeles, CA, USA.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Lee
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University Southern California, Los Angeles, CA, USA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Goodwin
authors.affiliation: Department of Endocrinology, Keck School of Medicine, University Southern California, Los Angeles, CA, USA.
authors.forename: Jorge H
authors.initials: JH
authors.lastname: Mestman
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D005260:Female; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology*; D008403:Mass Screening / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D011863:Radioimmunoassay; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013959:Thyroid Diseases / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D013960:Thyroid Function Tests; D055815:Young Adult
chemical_list: D001323:Autoantibodies; D007453:Iodide Peroxidase