An effective analysis of screening strategies for thyroid disorders during early pregnancy
10.3760/cma.j.issn.1000-6699.2010.11.004
- VernacularTitle:妊娠早期甲状腺功能筛查策略的有效性分析
- Author:
Weiwei WANG
;
Xiaohui YU
;
Weiping TENG
;
Zhongyan SHAN
;
Sen WANG
;
Jianxin LI
;
Chenyang LI
;
Weiwei ZHOU
;
Bo GAO
;
Tao SHANG
;
Jiaren ZHOU
;
Bin DING
;
Ying MA
;
Ying WU
;
Hui XU
;
Wei LIU
;
Jia LI
;
Yanyan CHEN
;
Lin ZHU
;
Jin ZHOU
;
Chenling FAN
;
Hong WANG
;
Hongmei ZHANG
- Publication Type:Journal Article
- Keywords:
First trimester pregnancy;
Screening;
Thyroid dysfunction;
Risk factors
- From:
Chinese Journal of Endocrinology and Metabolism
2010;26(11):926-930,953
- CountryChina
- Language:Chinese
-
Abstract:
Objective To use the first trimester-specific reference intervals of thyroid-related hormones to explore the prevalence of thyroid dysfunction during early pregnancy and to analyze effectiveness of different screening strategies. Methods In this study 2 899 pregnant women were enrolled during the first trimester of gestation. TSH, FT4, FT3, and thyroid peroxidase antibody (TPOAb) were measured and thyroid disorders of pregnant women were diagnosed based on the first trimester-specific reference intervals. Results The prevalence of hypothyroidism was significantly higher in the high-risk group than in the non-high risk group ( 16.3% vs 5.3%,RR = 3.1,95% CI 2.4-4.0, P＜0.01 ). TPOAb ( RR = 4.7, 95 % CI 3.6-6.0, P＜0.01 ), and personal history of thyroid diseases ( RR=3.2, 95% CI 1.9-5.4, P＜0.01 ) increased the risk of hypothyroidism. The prevalence of hyperthyroidism was higher in the high-risk group (3.1% vs 1.4%, P = 0. 006, RR = 2.2, 95% CI 1.2-3.9, P=0.006). TPOAb (RR=2.6, 95%CI 1.3-5.0, P=0.007), and presence of personal history of thyroid diseases( RR=4.7, 95% CI 1.7-12.5, P=0.006) also increased the risk of hyperthyroidism. 56.7% women with hypothyroidism and 64. 7% women with hyperthyroidism were in the non-high risk group. Conclusion We recommend that screening all pregnant women for thyroid disorders in the first trimester with TSH, FT4, and TPOAb is more effective than the case-finding approach.
