The New York Times‘ Ingfei Chen reported on the debate over the screening of pregnant women for thyroid disorders that may endanger the fetuses they are carrying. The pregnancy-related consequences of various thyroid disorders may include increased risk of miscarriage, retardation of fetal brain development and premature birth, among other hazards.
… because thyroid problems can easily go undiagnosed, the hazards have also set off a debate over whether every woman who is pregnant or planning to be should have a blood test to check her thyroid. That test measures for thyroid-stimulating hormone, or T.S.H., which spurs the gland’s hormone production.
Most doctors’ groups have not endorsed universal prenatal thyroid screening, citing uncertainties over whether it would yield health benefits justifying the expense of testing in roughly 6.4 million pregnancies each year and educating doctors to read results that are tricky to interpret.
Even selective screening of at-risk patients, endorsed by many professionals, may not be effective enough, Chen found.
A British study found that such testing missed 30 percent of those with hypothyroidism and 69 percent of those with hyperthyroidism.
For now, until there is confirmation that treatment truly helps, Dr. Stagnaro-Green said he still favored selective thyroid screening. But he added, “My belief is that data will be forthcoming that will push us towards universal screening.”
Studies underway will track mothers with thyroid disorders and the effect of the disorders and, in some cases, medication to remedy them, and their cumulative effect on the IQ of the children born to those mothers once they reach 5 years of age.
This week, at the Research Summit and Spring Symposium of the American Thyroid Association, members will discuss “Thyroid Hormone in Pregnancy and Development” and “Thyroid Dysfunction and Pregnancy: Miscarriage, Preterm Delivery and Decreased IQ.” Find the Association’s Fact Sheet on the Thyroid and Pregnancy here.
The debate over prenatal thyroid testing is just starting to heat up. Those involved would do well to look at more developed testing debates, such as bone density, cancers, tumors and anormalities, and even the growing field of DNA testing.
Earlier posts about debate about screenings.