title: Should all women be screened for thyroid dysfunction in pregnancy?
abstract: The subject of universal thyroid screening in pregnancy generates impassioned debate. Thyroid dysfunction is common, has significant adverse implications for fetal and maternal well-being, is readily detectable and can be effectively and inexpensively treated. Furthermore, the currently recommended case-finding strategy does not identify a substantially proportion of women with thyroid dysfunction thus favoring universal screening. On the other hand subclinical thyroid dysfunction forms the bulk of gestational thyroid disorders and the paucity of high-level evidence to support correction of these asymptomatic biochemical abnormalities weighs against universal screening. This review critically appraises the literature, examines the pros and cons of universal thyroid screening in pregnancy, highlighting the now strong case for implementing universal screening and explores strategies for its implementation.
authors.affiliation: Thyroid Research Group, Institute of Molecular & Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK.
authors.forename: Peter N
authors.initials: PN
authors.lastname: Taylor
authors.affiliation: Thyroid Research Group, Institute of Molecular & Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK.
authors.forename: Onyebuchi E
authors.initials: OE
authors.lastname: Okosieme
authors.affiliation: Thyroid Research Group, Institute of Molecular & Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK.
authors.forename: Lakdasa
authors.initials: L
authors.lastname: Premawardhana
authors.affiliation: Thyroid Research Group, Institute of Molecular & Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK.
authors.forename: John H
authors.initials: JH
authors.lastname: Lazarus
mesh_terms: D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000097:blood / Q000175:diagnosis; D007037:Hypothyroidism / Q000097:blood / Q000175:diagnosis; D018828:Immunoglobulins, Thyroid-Stimulating / Q000097:blood; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000175:diagnosis*; D011295:Prenatal Care / Q000379:methods*; D013959:Thyroid Diseases / Q000097:blood* / Q000175:diagnosis*; D013960:Thyroid Function Tests; D013963:Thyroid Hormones / Q000097:blood
chemical_list: D018828:Immunoglobulins, Thyroid-Stimulating; D013963:Thyroid Hormones
keywords: child neurodevelopment; hyperthyroidism; hypothyroidism; isolated hypothyroxinemia; levothyroxine; pregnancy; screening; subclinical hypothyroidism