Taylor Peter N, Okosieme Onyebuchi E, Premawardhana Lakdasa, Lazarus John H
Thyroid Research Group, Institute of Molecular & Experimental Medicine, Cardiff University School of Medicine, Cardiff, UK.
Womens Health (Lond). 2015 Jun;11(3):295-307. doi: 10.2217/whe.15.7.
The subject of universal thyroid screening in pregnancy generates impassioned debate. Thyroid dysfunction is common, has significant adverse implications for fetal and maternal well-being, is readily detectable and can be effectively and inexpensively treated. Furthermore, the currently recommended case-finding strategy does not identify a substantially proportion of women with thyroid dysfunction thus favoring universal screening. On the other hand subclinical thyroid dysfunction forms the bulk of gestational thyroid disorders and the paucity of high-level evidence to support correction of these asymptomatic biochemical abnormalities weighs against universal screening. This review critically appraises the literature, examines the pros and cons of universal thyroid screening in pregnancy, highlighting the now strong case for implementing universal screening and explores strategies for its implementation.
孕期甲状腺功能的普遍筛查这一话题引发了激烈的争论。甲状腺功能障碍很常见，对胎儿和母亲的健康有重大不利影响，易于检测，且能得到有效且低成本的治疗。此外，目前推荐的病例发现策略无法识别出相当一部分甲状腺功能障碍的女性，因此支持普遍筛查。另一方面，亚临床甲状腺功能障碍构成了妊娠期甲状腺疾病的主要部分，而支持纠正这些无症状生化异常的高级证据匮乏，这不利于普遍筛查。本综述对文献进行了批判性评估，审视了孕期普遍甲状腺筛查的利弊，强调了目前实施普遍筛查的有力理由，并探讨了实施策略。
