Should Screening for Thyroid Peroxidase during Pregnancy Be Universal or Risk-Factor-Based?

Background The wide range of adverse outcomes of thyroid dysfunction and autoimmunity on pregnancy and the offspring (1-5) makes early and reliable detection of paramount importance; therefore, screening for thyroid dysfunction is recommended in pregnancy. However, it is not yet clear whether screening should be clinically oriented or universal. Targeted case finding for the presence of antithyroid peroxidase antibodies (TPOAb) in pregnancy has not yet been evaluated despite the high prevalence in the general female population (1, 6, 7). The aim of the study was to assess whether, in pregnant women, screening for TPOAb should be restricted to women considered at high risk for thyroid autoimmune disease or whether screening should be universal.