O hormônio estimulante da tireoide (TSH) é o único teste indicado para o rastreamento do hipotireoidismo primário.[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
Muitos países rastreiam todos os neonatos quanto a hipotireoidismo primário para prevenir a deficiência 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
A US Preventive Services Task Force determinou que não há evidências suficientes para recomendar ou não o rastreamento da doença tireoidiana em adultos não gestantes e assintomáticos.[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
Rastreamento na gestação
Não há evidências de que o rastreamento universal na gestação melhore os desfechos da gestação.[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
[ 
]
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/fullMostre-me a resposta No entanto, parece prudente realizar um rastreamento direcionado das gestantes com aumento do risco de hipotireoidismo.[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
O American College of Obstetricians and Gynecologists recomenda testes de função tireoidiana em gestantes com aumento do risco de doença tireoidiana (história pessoal ou familiar de doença tireoidiana, diabetes do tipo 1, suspeita clínica de doença tireoidiana).[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
A American Thyroid Association recomenda o rastreamento de doenças tireoidianas em gestantes e naquelas que planejam engravidar, caso sejam identificados fatores de risco.[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
Isso inclui mulheres com história de doença tireoidiana ou anticorpos antitireoperoxidase, história familiar de doença tireoidiana, sintomas de hipotireoidismo, risco de deficiência de iodo, diabetes mellitus do tipo I, aborto recorrente ou história de radiação de cabeça e pescoço.
As elevações nas concentrações séricas do TSH durante a gravidez devem ser idealmente definidas por meio de intervalos de referência específicos para gestação (trimestre) e população.[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