Screening for thyroid disorders during pregnancy: Results of a survey in Maine

Guidelines regarding prenatal screening for thyroid deficiency are conflicting, and current practice in primary care settings is unknown. Our survey sought to determine the: 1) extent of screening in Maine; 2) factors associated with screening; and 3) laboratory cut-off levels used. In 2004 we surve...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2006-02, Vol.194 (2), p.471-474
Main Authors: Haddow, James E., McClain, Monica R., Palomaki, Glenn E., Kloza, Edward M., Williams, Josephine
Format: Article
Language:English
Subjects:
Biological and medical sciences
Endocrinopathies
Family Practice - statistics & numerical data
Female
Gynecology. Andrology. Obstetrics
Health Care Surveys
Humans
Maine
Mass Screening - utilization
Medical sciences
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Obstetrics - statistics & numerical data
Practice Patterns, Physicians
Pregnancy
Pregnancy Complications - diagnosis
Prenatal Care - statistics & numerical data
Reference ranges
Reference Values
Thyroid Diseases - diagnosis
Thyroid testing
Thyroid. Thyroid axis (diseases)
Thyrotropin - blood
TSH
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Summary:Guidelines regarding prenatal screening for thyroid deficiency are conflicting, and current practice in primary care settings is unknown. Our survey sought to determine the: 1) extent of screening in Maine; 2) factors associated with screening; and 3) laboratory cut-off levels used. In 2004 we surveyed 61 prenatal care practices, representing 246 practitioners and 85% of Maine deliveries. Screening via thyroid-stimulating hormone (TSH) testing was routine in 48% of the practices. Obstetrician practices screened at a significantly higher rate than family practices (56% vs 8%; odds ratio [OR] 15.0, 95% CI 1.9-130.0). Nonsignificant higher rates were found for urban versus rural, and multipractitioner versus solo practices. The lower TSH cut-off levels ranged between 0.1 and 0.5 mU/L among practices; the upper cut-off levels ranged between 3.5 and 5.5 mU/L. Prenatal screening for thyroid deficiency varies among practices, reflecting conflicting guidelines. TSH cut-offs are also variable and might benefit from standardization.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2005.07.055