Thyroid Function Testing During Pregnancy After Partial Thyroidectomy Versus the General Population: A Nationwide...

Area of Science:

• Endocrinology
• Obstetrics
• Public Health

Background:

• Thyroid function screening in pregnancy is debated, with guidelines recommending surveillance for high-risk groups.
• Variability exists in screening intensity and follow-up protocols for pregnant individuals.

Purpose of the Study:

• To compare thyroid function surveillance frequency and outcomes between pregnant women post-partial thyroidectomy and the general pregnant population.
• To assess the incidence of gestational hypothyroidism in these groups.

Main Methods:

• A national retrospective matched cohort study analyzed data from 2002-2023.
• Compared pregnancies in women with prior partial thyroidectomy (exposure group) to those without (non-exposure group).
• Primary outcome: frequency of serum thyroid-stimulating hormone (TSH) measurements; Secondary outcome: gestational hypothyroidism incidence.

Main Results:

• 81% of partial thyroidectomy pregnancies had TSH measured vs. 62% in the general population (P < .01).
• 18% of partial thyroidectomy pregnancies had TSH testing across all trimesters vs. 3% (P < .01).
• Elevated TSH prevalence was higher in the partial thyroidectomy group (9% vs 4%, P < .01).

Conclusions:

• Thyroid screening during pregnancy remains suboptimal.
• Pregnant individuals post-partial thyroidectomy receive more intensive monitoring, acknowledging their high-risk status.
• Findings emphasize the necessity for enhanced implementation of risk-based thyroid surveillance in pregnancy.