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Journal of Thyroid Research
Volume 2013, Article ID 851326, 8 pages
Review Article

Screening for Maternal Thyroid Dysfunction in Pregnancy: A Review of the Clinical Evidence and Current Guidelines

Section of Endocrinology, Diabetes and Nutrition, Boston University School of Medicine and Boston Medical Center, 88 East Newton Street, Evans 201, Boston, MA 02118, USA

Received 12 December 2012; Accepted 22 April 2013

Academic Editor: Fereidoun Azizi

Copyright © 2013 Donny L. F. Chang and Elizabeth N. Pearce. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Observational studies have demonstrated that maternal thyroid dysfunction and thyroid autoimmunity in pregnancy may be associated with adverse obstetric and fetal outcomes. Treatment of overt maternal hyperthyroidism and overt hypothyroidism clearly improves outcomes. To date there is limited evidence that levothyroxine treatment of pregnant women with subclinical hypothyroidism, isolated hypothyroxinemia, or thyroid autoimmunity is beneficial. Therefore, there is ongoing debate regarding the need for universal screening for thyroid dysfunction during pregnancy. Current guidelines differ; some recommend an aggressive case-finding approach, whereas others advocate testing only symptomatic women or those with a personal history of thyroid disease or other associated medical conditions.