Screening strategies for thyroid disorders in the first and second trimester of pregnancy in China
| Autor: | Lingqiao Cai, Xuemian Lu, Hong Yang, Minglong Shao, Qing-Shou Chen, Lechu Yu, Zhenzhen Lin, Chi Zhang, Liangmiao Chen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
endocrine system diseases
Physiology Thyrotropin lcsh:Medicine Thyroid Function Tests Endocrinology Pregnancy Prenatal Diagnosis Medicine and Health Sciences Prevalence lcsh:Science Subclinical infection Thyroid Multidisciplinary medicine.diagnostic_test biology Obstetrics Pregnancy Outcome medicine.anatomical_structure Pregnancy Trimester Second Female Anatomy Research Article Adult China medicine.medical_specialty endocrine system Endocrine System Physical examination Thyroid function tests Young Adult Thyroid-stimulating hormone Thyroid peroxidase medicine Humans Gynecology Endocrine Physiology business.industry lcsh:R Biology and Life Sciences medicine.disease Thyroid Diseases Thyroid disorder Pregnancy Complications Pregnancy Trimester First Thyroxine biology.protein lcsh:Q business |
| Zdroj: | PLoS ONE, Vol 9, Iss 6, p e99611 (2014) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Background Thyroid dysfunction during pregnancy is associated with multiple adverse outcomes, but whether all women should be screened for thyroid disorders during pregnancy remains controversial. Objective To evaluate the effectiveness of the targeted high risk case-finding approach for identifying women with thyroid dysfunction during the first and second trimesters of pregnancy. Methods Levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), and thyroid peroxidase antibodies (TPOAb) were measured in 3882 Chinese women during the first and second trimester of pregnancy. All tested women were divided into the high risk or non-high risk groups, based on their history, findings from physical examination, or other clinical features suggestive of a thyroid disorder. Diagnosis of thyroid disorders was made according to the standard trimester-specific reference intervals. The prevalence of thyroid disorders in each group was determined, and the feasibility of a screening approach focusing exclusively on high risk women was evaluated to estimate the ability of finding women with thyroid dysfunction. Results The prevalence of overt hypothyroidism or hyperthyroidism in the high risk group was higher than in the non-high risk group during the first trimester (0.8% vs 0, χ2 = 7.10, p = 0.008; 1.6% vs 0.2%, χ2 = 7.02, p = 0.008, respectively). The prevalence of hypothyroxinemia or TPOAb positivity was significantly higher in the high risk group than in the non-high risk group during the second trimester (1.3% vs 0.5%, χ2 = 4.49, p = 0.034; 11.6% vs 8.4%, χ2 = 6.396, p = 0.011, respectively). The total prevalence of hypothyroidism or hyperthyroidism and the prevalence of subclinical hypothyroidism or hyperthyroidism were not statistically different between the high risk and non-high risk groups, for either the first or second trimester. Conclusion The high risk screening strategy failed to detect the majority of pregnant women with thyroid disorders. Therefore, we recommend universal screening of sTSH, FT4, and TPOAb during the first trimester and second trimester of pregnancy. |
| Databáze: | OpenAIRE |
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