Haddow James E, McClain Monica R, Palomaki Glenn E, Kloza Edward M, Williams Josephine
Foundation for Blood Research, Scarborough, ME, USA.
Am J Obstet Gynecol. 2006 Feb;194(2):471-4. doi: 10.1016/j.ajog.2005.07.055.
Guidelines regarding prenatal screening for thyroid deficiency are conflicting, and current practice in primary care settings is unknown. Our survey sought to determine the: 1) extent of screening in Maine; 2) factors associated with screening; and 3) laboratory cut-off levels used.
In 2004 we surveyed 61 prenatal care practices, representing 246 practitioners and 85% of Maine deliveries.
Screening via thyroid-stimulating hormone (TSH) testing was routine in 48% of the practices. Obstetrician practices screened at a significantly higher rate than family practices (56% vs 8%; odds ratio [OR] 15.0, 95% CI 1.9-130.0). Nonsignificant higher rates were found for urban versus rural, and multipractitioner versus solo practices. The lower TSH cut-off levels ranged between 0.1 and 0.5 mU/L among practices; the upper cut-off levels ranged between 3.5 and 5.5 mU/L.
Prenatal screening for thyroid deficiency varies among practices, reflecting conflicting guidelines. TSH cut-offs are also variable and might benefit from standardization.
关于甲状腺功能减退症产前筛查的指南存在冲突，目前基层医疗环境中的实际做法尚不清楚。我们的调查旨在确定：1）缅因州的筛查范围；2）与筛查相关的因素；3）所使用的实验室临界值水平。
2004年，我们对61家产前护理机构进行了调查，这些机构代表了246名从业者以及缅因州85%的分娩情况。
48%的机构常规通过促甲状腺激素（TSH）检测进行筛查。产科机构的筛查率显著高于家庭医疗机构（56%对8%；优势比[OR]15.0，95%可信区间1.9 - 130.0）。城市与农村、多从业者机构与单从业者机构之间的筛查率虽有差异但不显著。各机构中较低的TSH临界值水平在0.1至0.5 mU/L之间；较高的临界值水平在3.5至5.5 mU/L之间。
甲状腺功能减退症的产前筛查在不同机构中存在差异，这反映了相互冲突的指南。TSH临界值也各不相同，标准化可能会有所助益。
