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Selective case finding versus universal screening for detecting hypothyroidism in the first trimester of pregnancy: a comparative evaluation of a group of pregnant women from Rio de Janeiro
Faculdade de MedicinaBerbara, Tatiana Martins Benvenuto Louro; Faculdade de MedicinaMorais, Nathalie Silva de; Faculdade de MedicinaSaraiva, Débora Ayres; Faculdade de MedicinaCorcino, Carolina Martins; Faculdade de MedicinaSchtscherbyna, Annie; Faculdade de MedicinaMoreira, Karina Lúcia; Faculdade de MedicinaTeixeira, Patrícia de Fátima dos Santos; Faculdade de MedicinaVaisman, Mario.
  • Faculdade de MedicinaBerbara, Tatiana Martins Benvenuto Louro; Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Faculdade de MedicinaBerbara, Tatiana Martins Benvenuto Louro. Rio de Janeiro. BR
  • Faculdade de MedicinaMorais, Nathalie Silva de; Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Faculdade de MedicinaMorais, Nathalie Silva de. Rio de Janeiro. BR
  • Faculdade de MedicinaSaraiva, Débora Ayres; Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Faculdade de MedicinaSaraiva, Débora Ayres. Rio de Janeiro. BR
  • Faculdade de MedicinaCorcino, Carolina Martins; Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Faculdade de MedicinaCorcino, Carolina Martins. Rio de Janeiro. BR
  • Faculdade de MedicinaSchtscherbyna, Annie; Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Faculdade de MedicinaSchtscherbyna, Annie. Rio de Janeiro. BR
  • Faculdade de MedicinaMoreira, Karina Lúcia; Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Faculdade de MedicinaMoreira, Karina Lúcia. Rio de Janeiro. BR
  • Faculdade de MedicinaTeixeira, Patrícia de Fátima dos Santos; Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Faculdade de MedicinaTeixeira, Patrícia de Fátima dos Santos. Rio de Janeiro. BR
  • Faculdade de MedicinaVaisman, Mario; Universidade Federal do Rio de Janeiro. Hospital Universitário Clementino Fraga Filho. Faculdade de MedicinaVaisman, Mario. Rio de Janeiro. BR
Arch. endocrinol. metab. (Online) ; 64(2): 159-164, Mar.-Apr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1131077
ABSTRACT
ABSTRACT Objective Maternal hypothyroidism during pregnancy may lead to adverse outcomes. Recently published guidelines by the American Thyroid Association (ATA) do not advocate for universal screening but recommend a case-finding approach in high-risk pregnant women. The present study aims to evaluate the accuracy of this approach in identifying women with thyroid dysfunction during early pregnancy. Subjects and methods This is a multiple-center, cross-sectional study. Three hundred and one pregnant women were enrolled. Anamnesis and a physical examination were performed to detect which women fulfilled the criteria to undergo laboratory screening of thyroid dysfunction, according to the ATA's 2017 guidelines. The Zulewski's validated clinical score was applied to assess signs and symptoms of hypothyroidism. Serum levels of thyrotropin (TSH), free thyroxine (FT4), anti-thyroperoxidase (TPO-Ab), and anti-thyroglobulin (Tg-Ab) antibodies were determined. Results Two hundred and thirty one women (78%) were classified as high risk, and 65 (22%) were classified as low risk for thyroid dysfunction. Regarding the clinical score, 75 patients (31.2%) presented mild symptoms that were compatible with SCH, of which 22 (7.4%) had symptoms as the only risk factor for thyroid disease. 17 patients (5.7%) had SCH, of which 10 (58.8%) belonged to the high-risk group, and 7 (41.2%) belonged to the low-risk group. OH was found in 4 patients (1.4%) 3 (75%) in the high-risk group and 1 (25%) in the low-risk group. Conclusions The ATA's proposed screening criteria were not accurate in the diagnosis of thyroid dysfunction in pregnancy. Testing only the high-risk pregnant women would miss approximately 40% of all hypothyroid patients.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Pregnancy Complications / Mass Screening / Hypothyroidism Type of study: Diagnostic study / Etiology study / Practice guideline / Observational study / Prevalence study / Prognostic study / Risk factors / Screening study Limits: Adult / Female / Humans / Pregnancy Language: English Journal: Arch. endocrinol. metab. (Online) Journal subject: Endocrinology / Metabolism Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal do Rio de Janeiro/BR

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Full text: Available Index: LILACS (Americas) Main subject: Pregnancy Complications / Mass Screening / Hypothyroidism Type of study: Diagnostic study / Etiology study / Practice guideline / Observational study / Prevalence study / Prognostic study / Risk factors / Screening study Limits: Adult / Female / Humans / Pregnancy Language: English Journal: Arch. endocrinol. metab. (Online) Journal subject: Endocrinology / Metabolism Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade Federal do Rio de Janeiro/BR