Risk-Based Screening for Thyroid Dysfunction during Pregnancy

Abstract

Objective. We conducted the study to see the incidence of thyroid dysfunction in women with obstetrical high-risk factors.Methods. We retrospectively reviewed medical charts of high-risk pregnant women who had examination for thyroid function during pregnancy. Women were divided according to clinical presentation, symptoms of thyroid disease and those with a personal history of thyroid disease (thyroid disease,n=32), intrauterine growth restriction (IUGR,n=115), diabetes mellitus (diabetes,n=115), hypertension (n=63), intrauterine fetal death (IUFD,n=52), and placental abruption (abruption,n=15). The incidence of thyroid dysfunctions including hyperthyroidism or hypothyroidism was compared.Results. The overall prevalence of thyroid dysfunction was 24.7%. The incidence of thyroid dysfunction in each group was as follows: 31% in thyroid disease, 25% in IUGR, 30% in diabetes, 27% in hypertension, 12% in IUFD, and 7% in abruption. Except IUFD, the incidence was not statistically significant from the group of thyroid disease (thyroid disease versus IUFD,P=0.03byχ2test). Thyroid disease represented for only 10% of all thyroid dysfunctions.Conclusion. Testing of women with a personal history or current symptoms of thyroid disease during pregnancy may be insufficient to detect women with thyroid dysfunction, who will become at high-risk pregnancy.