One-step or two-step screening for thyroid diseases during early pregnancy: which is better?

• DOI: 10.3760/cma.j.issn.1007-9408.2016.03.006
• Publication Date: 2016-03-16
• Authors: Li Zhang; Weijie Sun; Ying Gao; Sainan Zhu; Youyuan Huang; Yang Zhang; Huixia Yang
• Keywords: Thyroid-stimulating hormone

Objective To investigate the appropriate screening method for thyroid diseases during early pregnancy.

Methods We collected information of 4 044 pregnant women who attended to Department Obstetrics and Gynecology Peking University First Hospital from September 1, 2013 30, 2014 antenatal care underwent one step in first trimester, which meant blood test stimulating hormone(TSH), free thyroxine(FT4) peroxidase antibody(TPOAb) at same time. Simulation analysis was performed on these with two-step (TSH then FT4 TPOAb if TSH abnormal). The incidence, missed diagnosis rate, costs screening, outcomes diagnosed cases were compared between one-step based cutoff value determined by American Thyroid Association (ATA) or our hospital (0.23-4.08 mU/L). positivel rate among three groups classified according (≥0.1-<2.5 mU/L, ≥2.5-<4.08 mU/L ≥4.08 T-test, Chi-square Fisher's exact applied statistical analysis.

Results When set ≥0.1- 0.05), including fetal distress, gestational diabetes mellitus, preterm birth, growth restriction, oligohydroamnios, polyhydroanmios, death, hypertension pre-eclampsia, placental abruptio neonatal asphyxia reported although no standard treatment had been provided, matter ATA recommendation unique reference adopted.

Conclusions We recommend function pregnancy. For purpose cost-saving, reduction avoidance overtreatment, management protocol should be individualized those 2.5 normal pregnancy.

Key words: Pregnancy complications; Thyroid diseases; Physician's practice patterns; Pregnancy