Department of Gynecology and Obstetrics, Shanghai Jiao Tong University Affiliated International Peace Maternity and Child Health Hospital , Shanghai , China.
Gynecol Endocrinol. 2013 Dec;29(12):1059-62. doi: 10.3109/09513590.2013.829448. Epub 2013 Sep 10.
The primary objective of this study is to explore the influence of different screening strategies on the prevalence of thyroid dysfunction and the missed diagnosis during pregnancy. A total of 1889 pregnant women (13-27 weeks) were divided into high-risk and low-risk groups according to the backgrounds of them collected by questionnaire. We detected the prevalence of thyroid dysfunction in high-risk groups and low-risk pregnant women by normal reference range during the second trimester in our research. High-risk groups accounted for 10.69% of all the pregnant women in this study. Using targeted high-risk case screening strategy, misdiagnosis rate of pregnancy with hyperthyroidism, subclinical hyperthyroidism, pregnancy with hypothyroidism, subclinical hypothyroidism, low T4 syndrome and positive TPOAb were 87.5% (14 cases), 87.08% (155 cases), 87.08% (155 cases), 83.93% (47 cases), 89.47% (17 cases) and 88.35% (91 cases), respectively. Furthermore, there was no statistically significant difference between high-risk group and low-risk group in the prevalence of thyroid dysfunction. Therefore, we believe that universal screening to pregnant women can effectively reduce misdiagnosis rate of thyroid dysfunction. Further, we recommend universal screening for thyroid function in second trimester of pregnancy.
本研究的主要目的是探讨不同筛查策略对妊娠期间甲状腺功能障碍的患病率和漏诊的影响。本研究共纳入 1889 名（13-27 周）孕妇，根据问卷调查收集的背景资料将其分为高危组和低危组。通过检测研究中所有孕妇的 10.69%的高危组和低危组孕妇在妊娠中期的甲状腺功能障碍患病率，采用有针对性的高危病例筛查策略，妊娠甲亢、亚临床甲亢、妊娠甲减、亚临床甲减、低 T4 血症和 TPOAb 阳性的误诊率分别为 87.5%（14 例）、87.08%（155 例）、87.08%（155 例）、83.93%（47 例）、89.47%（17 例）和 88.35%（91 例）。此外，高危组和低危组之间甲状腺功能障碍的患病率无统计学差异。因此，我们认为对孕妇进行普遍筛查可以有效降低甲状腺功能障碍的误诊率。进一步建议在妊娠中期对甲状腺功能进行普遍筛查。
