When you think of pregnancy, you probably think of the hormones involved in conceiving and sustaining a healthy pregnancy. After all, human chorionic gonadotropin hormone (hCG) is the hormone that tells us where pregnant, and the hormone that we monitor in those crucial early weeks to make sure things are progressing normally. But did you know that it's not only reproductive hormones that are vital to a healthy pregnancy?
A fetus is completely reliant on thyroid hormones from the mother for up to the first 16 weeks of gestation. That is a critical period for brain development! However, many women of childbearing age have abnormal thyroid function, which can affect their thyroid hormone levels. But pregnant women are not routinely tested for thyroid issues.
According to a new study, this can mean that doctor's are missing a chance to improve fetal and maternal health.
The study published in Frontiers in Endocrinology argues that universal thyroid screening in early pregnancy can improve outcomes for fetal development, maternal health, impact future IQ levels for fetuses, and lower the risk of premature birth, pre-eclampsia, and other pregnancy complications. Universal screening in already standard in other countries like Spain, China, and Poland.
But countries like the UK and US opt for a different approach. They only screen women that are considered high-risk for thyroid dysfunction. Women are considered high-risk of they have clinical signs or symptoms, an autoimmune diseases, or previous preterm deliveries.
Universal screening is a cost-effective way to identify a potentially serious issue that can greatly impact a baby's future and health. So why don't we do it? Doctors weigh the risk and benefit of treating women who may have no symptoms or borderline test results. Overdiagnosis and potential over-treatment in these cases does carry risks, and could negate the benefits of universal screening.
Ideally, women would be screened as soon as they found out they were pregnant. Screening in early pregnancy could potentially improve child IQ and reduce pregnancy complications. Hopefully, a consensus can be reached on how to make this practical and reduce the risk of misdiagnosis, overdiagnosis, and over-treatment of thyroid dysfunction.