Reduced thyroid function during pregnancy can have adverse effects on both the mother and fetus, including increased risk of miscarriage and preterm labor.
Thyroid autoimmunity also puts the mother at increased risk of developing postpartum thyroiditis and hypothyroidism in the future. While screening of high-risk women for thyroid dysfunction is recommended, universal screening of pregnant women remains controversial.
Chrysoula Dosiou, MD,developed a computer model to compare the cost-effectiveness of three screening strategies: universal screening with thyroid-stimulating hormone and anti-thyroid peroxidase antibodies during the first trimester, risk-based screening, and no screening. In this model, a positive screening test led to follow-up testing and treatment with thyroid hormone when indicated.
The model takes into account the development of adverse obstetrical outcomes during pregnancy, postpartum thyroiditis, and overt hypothyroidism during a woman’s lifetime.
According to data presented today at the 81st Annual Meeting of the American Thyroid Association (ATA), universal screening for autoimmune thyroid disease in the first trimester of pregnancy is cost-effective compared with screening of only high-risk women.
Both the risk-based and universal screening options are cost-effective when relative to no screening.