Universal screening for thyroid disease during pregnancy should be performed

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Public Health

Background:

• Overt thyroid disease (hypothyroidism and hyperthyroidism) affects 1% of pregnancies.
• Untreated overt thyroid disease is linked to miscarriage and preterm delivery.
• Current targeted screening misses a significant number of affected pregnancies.

Purpose of the Study:

• To advocate for universal screening for thyroid disease in pregnancy.
• To highlight the benefits of early detection and treatment of overt thyroid disease.
• To emphasize the cost-effectiveness of universal screening.

Main Methods:

• Review of human and animal studies on thyroid disease in pregnancy.
• Analysis of the impact of overt, subclinical, and autoimmune thyroid disease on pregnancy outcomes.
• Comparison of universal screening versus targeted screening strategies.

Main Results:

• Universal screening identifies patients with overt thyroid disease requiring treatment.
• Early detection and treatment of overt thyroid disease decrease adverse pregnancy outcomes.
• Universal screening is cost-effective and potentially cost-saving.

Conclusions:

• Universal screening for thyroid disease in pregnancy is essential for improving maternal and infant health.
• The benefits of universal screening for overt thyroid disease are independent of subclinical or autoimmune thyroid disease.
• Implementing universal screening is timely and recommended.