Document Detail


Is Measurement of Maternal Serum TSH Sufficient Screening in Early Pregnancy? A Case for More Randomized Trials.
MedLine Citation:
PMID:  22788877     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
During the past decades, observational studies have demonstrated a relationship between thyroid dysfunction in pregnancy and a range of adverse outcomes in both mother and offspring. However, results from the few randomized trials of screening for thyroid dysfunction in pregnant women have not shown any benefit for women or their children. Before implementing screening in pregnant women at population level, randomized trials are needed to show that screening with subsequent intervention is effective for mothers or children. Here, we review the literature and argue that the findings from existing trials are not conclusive. Until such conclusive evidence from randomized trials is available, the best advice to the clinician is to screen only high risk pregnant women. Such women, e.g. those with symptoms or a history of thyroid problems, should be screened using trimester-specific reference ranges for TSH levels. We recommend new prospective randomized trials that combine different thyroid parameters as the screening tool, apply trimester-specific ranges for thyroid hormones, and examine whether screening and intervention during the first trimester of pregnancy will improve neuropsychological outcomes in the offspring. © 2012 Blackwell Publishing Ltd.
Authors:
Akhgar Ghassabian; Henning Tiemeier
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-12
Journal Detail:
Title:  Clinical endocrinology     Volume:  -     ISSN:  1365-2265     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
Affiliation:
Department of Child and Adolescent Psychiatry, Erasmus Medical Centre-Sophia Children Hospital, Rotterdam, the Netherlands.
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