Investigation onto thyroid dysfunction and autoantibody screening in second and third trimesters of pregnancy / 中华内分泌代谢杂志

ABSTRACT

Objective To investigate the prevalence of thyroid disorders and positive thyroid autoantibodies,and evaluate the necessity for universal thyroid screening during the second and third trimesters of pregnancy.Methods The pregnant women during the second and third trimesters who visited Shanghai Jiaotong University Affiliated First People's Hospital between June 2006 and February 2008 were chosen for thyroid screening by determining serum free triiodothyronine,free thyroxine,thyrotropin,thyroid peroxidase antibody (TPOAb),and thyrotropin receptor antibody.A personal and family history of thyroid disease and other autoimmune diseases was investigated by questionnaire.The pregnant women were divided into high risk or low risk groups for thyroid disease based on their personal or family histories.Results A total of 2 101 pregnant women were screened,712 ( 33.89％ ) of them were identified to suffer from thyroid disorders or with positive thyroid autoantibody.The prevalence of thyroid dysfunction was increased in high risk group.While in low risk group( n =1 983 ),the prevalence of clinical hypothyroidism was 2.27％ ( n =45 ),subclinical hypothyroidism 11.60％ ( n =230 ),clinical hyperthyroidism 0.20％ ( n =4 ),subclinical hyperthyroidism 1.06％ ( n =21 ),hypothyroxinemia 6.45％ ( n =128 ),and euthyroid with positive TPOAb 10.74％ ( n =213 ) in our study.Pregnant women with positive TPOAb were susceptible to thyroid dysfunction.It was shown that 79.74％ of pregnant women with thyroid disorders were diagnosed by universal thyroid screening.Conclusions 33.89％ of pregnant women in the second and third trimesters were identified to suffer from thyroid disorders or positive thyroid autoantibody by universal thyroid screening.Increased prevalence of thyroid dysfunction was found in pregnant women with positive TPOAb.79.74％ of pregnant women with thyroid disorders might be missed if screening was made only in the high risk cases.