The results support the concept of a reflex TPO antibody measurement in women with a thyrotropin concentration higher than 4.0 mIU/L, and gestational thyrotropin monitoring for TPO antibody–positive women prior to conception.
Several recent large, well-done clinical trials that assessed the effect of routine pregnancy screening for and thyroid hormone treatment of subclinical hypothyroidism, isolated hypothyroxinemia, and TPO antibody positivity have failed to show benefit. It seems plausible that these thyroid testing abnormalities may reflect other nonthyroidal processes rather than thyroid dysfunction.
Association of Thyroid Function Test Abnormalities and Thyroid Autoimmunity With Preterm Birth: A Systematic Review and Meta-analysis
Editorial: Thyroid Function Test Abnormalities During Pregnancy
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