Detection of thyroid dysfunction in pregnant women: Universal screening is justified

Lluís Vila, Inés Velasco, Stella González, Francisco Morales, Emilia Sánchez, José Maria Lailla, Txanton Martinez-Astorquiza, Manel Puig-Domingo, Jose Arena, Susana Ares, Juan José Arrizabalaga, Teresa Arrobas, Nivela Bandrés, Orosia María, Pere Berbel, Carolina Bezanilla López, Águeda Caballero, Antonio de la Vieja Escolar, Sergio Donnay Candil, Mercedes EspadaEduardo García Fuentes, Carmen Gonzalez Mateo, Alfonso Gentil, Teresa Iglesias Reymunde, Anna Lucas, Jose Muñoz Marquez, Edelmiro Menendez, Maria C. del Carmen Millon Ramirez, Gracia Moll Mascaró, Francisco Morales, Jose Carlos Moreno, Jose Javier Pineda Arrivas, Manel Puig-Domingo, María Riestra, Piedad Santiago, Pilar Santiesteban, Federico Soriguer, María Teresa Torres Costa, Frederic Tortosa, Inés Velasco, Francisca Vich Sastre, Lluís Vila, Silvia Wengrowicz

Research output: Contribution to journalArticleResearchpeer-review

38 Citations (Scopus)

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. © 2012 SEEN.
Original languageEnglish
Pages (from-to)547-560
JournalEndocrinologia y Nutricion
Volume59
Issue number9
DOIs
Publication statusPublished - 1 Nov 2012

Keywords

  • Pregnancy
  • Screening
  • Thyroid dysfunction

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