Screening

Pregnant and postpartum women

Universal screening for thyroid disease in pregnancy is not recommended. However, US guidelines recommend case finding and targeted screening for women at increased risk.[32][33]​​

The American College of Obstetricians and Gynecologists recommends thyroid function testing should be performed in women with a personal or family history of thyroid disease, type 1 diabetes, or clinical suspicion of thyroid disease.​[33]

American Thyroid Association guidelines suggest screening in pregnant women or those planning pregnancy with:[32]

  • History of hypothyroidism/hyperthyroidism or current symptoms/signs of thyroid dysfunction

  • Known thyroid antibody positivity or presence of a goiter

  • History of head or neck radiation or prior thyroid surgery

  • Age >30 years

  • Type 1 diabetes or other autoimmune disorders

  • History of pregnancy loss, preterm delivery, or infertility

  • Multiple prior pregnancies (>2)

  • Family history of autoimmune thyroid disease or thyroid dysfunction

  • Class 3 obesity (BMI >40 kg/m²; also categorized as extreme or severe obesity)

  • Use of amiodarone or lithium, or recent administration of iodinated radiologic contrast

  • Residing in an area of known moderate to severe iodine insufficiency

Elevations in serum thyroid-stimulating hormone (TSH) concentrations during pregnancy should ideally be defined using pregnancy (trimester) and population-specific reference ranges.[32]

Note that postpartum thyroid dysfunction may not be recognized by women who attribute symptoms to lack of sleep and breast-feeding.[17]

Use of this content is subject to our disclaimer