Jan 15 2009
Paul Ladenson, MD, Director of the Division of Endocrinology and Metabolism at Johns Hopkins Medical School in Baltimore reviewed the benefits and costs of identifying pregnant women at risk of hypothyroidism. He concluded that "gestational hypothyroidism probably occurs with a significant incidence; TSH testing can diagnose the condition and thyroxine can treat it; and maternal and fetal consequences appear to be clinically significant based on anecdote and small clinical trials, and reversibility could be predicted." However, he added, "Evidence from definitive prospective, randomized clinical trials is lacking, and the cost of this new preventive medical intervention would be substantial."
"While most of the experts agreed that current scientific data falls short of supporting immediate widespread population screening for thyroid disease and thyroid autoimmunity," said Gregory Brent, MD, of the UCLA School of Medicine and the ATA Secretary, "there is sufficient information to recommend some interim measures and guidance for additional data that is required to design an effective screening program."
The ATA statement includes a "plan for action" that calls on governmental institutions, such as the Centers for Disease Control and Prevention; professionals organizations, such as the ATA and AACE; and nongovernmental groups, such as the March of Dimes, to implement a coordinated program of patient education, practice review, and research on the impact of maternal thyroid status on pregnancy and fetal and childhood development.
More information on the ATA statement and guidelines is available online.
Source:
ATA Public Health Statement, "American Thyroid Association (ATA) Statement on Early Maternal Thyroidal Insufficiency: Recognition, Clinical Management and Research Directions,"
April 26, 2004, Online
