La hormona estimulante de la tiroides (TSH) es la única prueba indicada para detectar el hipotiroidismo primario.[32]LeFevre ML, U.S. Preventive Services Task Force. Screening for thyroid dysfunction: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2015 May 5;162(9):641-50.
https://www.acpjournals.org/doi/full/10.7326/M14-1456?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org
http://www.ncbi.nlm.nih.gov/pubmed/25798805?tool=bestpractice.com
Muchos países detectan hipotiroidismo primario en todos los recién nacidos para prevenir la discapacidad intelectual.[33]Rastogi MV, LaFranchi SH. Congenital hypothyroidism. Orphanet J Rare Dis. 2010 Jun 10;5:17.
https://www.doi.org/10.1186/1750-1172-5-17
http://www.ncbi.nlm.nih.gov/pubmed/20537182?tool=bestpractice.com
[34]Kopel J. A global perspective on newborn congenital hypothyroidism screening. Proc (Bayl Univ Med Cent). 2020 Jan;33(1):137-9.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6988672
http://www.ncbi.nlm.nih.gov/pubmed/32063801?tool=bestpractice.com
[35]Rose SR, Wassner AJ, Wintergerst KA, et al. Congenital hypothyroidism: screening and management. Pediatrics. 2023 Jan 1;151(1):e2022060419.
https://publications.aap.org/pediatrics/article/151/1/e2022060419/190311/Congenital-Hypothyroidism-Screening-and-Management?autologincheck=redirected
http://www.ncbi.nlm.nih.gov/pubmed/36827523?tool=bestpractice.com
El US Preventive Services Task Force determinó que no hay suficiente evidencia para emitir una recomendación a favor o en contra del cribado para la detección de enfermedades tiroideas en adultos asintomáticos y mujeres adultas no embarazadas asintomáticas.[32]LeFevre ML, U.S. Preventive Services Task Force. Screening for thyroid dysfunction: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2015 May 5;162(9):641-50.
https://www.acpjournals.org/doi/full/10.7326/M14-1456?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org
http://www.ncbi.nlm.nih.gov/pubmed/25798805?tool=bestpractice.com
[36]Rugge JB, Bougatsos C, Chou R. Screening and treatment of thyroid dysfunction: an evidence review for the US Preventive Services Task Force. Ann Intern Med. 2015 Jan 6;162(1):35-45.
http://annals.org/article.aspx?articleid=1919872
http://www.ncbi.nlm.nih.gov/pubmed/25347444?tool=bestpractice.com
Cribado durante el embarazo
No existe evidencia sólida de que el cribado universal durante el embarazo mejore los resultados del embarazo.[37]Vissenberg R, van den Boogaard E, van Wely M, et al. Treatment of thyroid disorders before conception and in early pregnancy: a systematic review. Hum Reprod Update. 2012 Jul;18(4):360-7.
http://www.ncbi.nlm.nih.gov/pubmed/22431565?tool=bestpractice.com
[38]Spencer L, Bubner T, Bain E, et al. Screening and subsequent management for thyroid dysfunction pre-pregnancy and during pregnancy for improving maternal and infant health. Cochrane Database Syst Rev. 2015 Sep 21;2015(9):CD011263.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011263.pub2/full
http://www.ncbi.nlm.nih.gov/pubmed/26387772?tool=bestpractice.com
[ 
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How does universal screening for thyroid dysfunction during pregnancy compare with no screening for improving maternal and infant outcomes?/cca.html?targetUrl=https://cochranelibrary.com/cca/doi/10.1002/cca.1096/fullMostrarme la respuesta Sin embargo, parece prudente realizar un cribado dirigido de mujeres embarazadas con mayor riesgo de hipotiroidismo.[39]Reid SM, Middleton P, Cossich MC, et al. Interventions for clinical and subclinical hypothyroidism pre-pregnancy and during pregnancy. Cochrane Database Syst Rev. 2013 May 31;(5):CD007752.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007752.pub3/full
http://www.ncbi.nlm.nih.gov/pubmed/23728666?tool=bestpractice.com
[40]Negro R, Schwartz A, Gismondi R, et al. Universal screening versus case finding for detection and treatment of thyroid hormonal dysfunction during pregnancy. J Clin Endocrinol Metab. 2010 Apr;95(4):1699-707.
http://www.ncbi.nlm.nih.gov/pubmed/20130074?tool=bestpractice.com
El American College of Obstetricians and Gynecologists recomienda realizar pruebas de función tiroidea en mujeres embarazadas que tienen un mayor riesgo de enfermedad tiroidea (antecedentes personales o familiares de enfermedad tiroidea, diabetes de tipo 1, sospecha clínica de enfermedad tiroidea).[41]American College of Obstetricians and Gynecologists. Thyroid disease in pregnancy: ACOG practice bulletin, number 223. Obstet Gynecol. 2020 Jun;135(6):e261-74.
http://www.ncbi.nlm.nih.gov/pubmed/32443080?tool=bestpractice.com
La American Thyroid Association recomienda la detección de la enfermedad de la tiroides en las mujeres embarazadas y en las que planean quedar embarazadas si se identifican los factores de riesgo.[29]Alexander EK, Pearce EN, Brent GA, et al. 2017 guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid. 2017 Mar;27(3):315-89.
http://online.liebertpub.com/doi/pdfplus/10.1089/thy.2016.0457
http://www.ncbi.nlm.nih.gov/pubmed/28056690?tool=bestpractice.com
Esto incluye pacientes con antecedentes de enfermedad tiroidea o anticuerpos antitiroperoxidasa, antecedentes familiares de enfermedad tiroidea, síntomas de hipotiroidismo, riesgo de deficiencia de yodo, diabetes mellitus de tipo I, aborto espontáneo recurrente o antecedentes de radiación de cabeza y cuello.
Lo ideal sería definir la elevación en las concentraciones séricas de TSH durante el embarazo utilizando el embarazo (trimestre) y los intervalos de referencia específicos de la población.[29]Alexander EK, Pearce EN, Brent GA, et al. 2017 guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum. Thyroid. 2017 Mar;27(3):315-89.
http://online.liebertpub.com/doi/pdfplus/10.1089/thy.2016.0457
http://www.ncbi.nlm.nih.gov/pubmed/28056690?tool=bestpractice.com