Maternal screening for hypothyroidism and thyroiditis using filter paper specimens

• Published in: Journal of women's health (Larchmont, N.Y. 2002) Vol. 22; no. 11; p. 991
• Main Authors: Foley, Jr, T P, Henry, J J, Hofman, L F, Thomas, R D, Sanfilippo, J S, Naylor, E W
• Format: Journal Article
• Language: English
• Published: United States 01.11.2013
• Subjects: Adolescent; Adult; Blood Specimen Collection - methods; Dried Blood Spot Testing - methods; Female; Humans; Hypothyroidism - blood; Hypothyroidism - diagnosis; Hypothyroidism - immunology; Mass Screening - methods; Middle Aged; Postpartum Period; Predictive Value of Tests; Pregnancy; Pregnancy Complications - blood; Pregnancy Complications - diagnosis; Pregnancy Complications - immunology; Pregnancy Trimester, First; Prenatal Diagnosis; Prospective Studies; Reproducibility of Results; Thyroid Function Tests; Thyroiditis, Autoimmune - blood; Thyroiditis, Autoimmune - diagnosis; Thyroiditis, Autoimmune - immunology; Thyrotropin - blood; Thyrotropin - immunology; Young Adult
• ISSN: 1931-843X
• DOI: 10.1089/jwh.2013.4393

Hypothyroidism and autoimmune thyroiditis are more prevalent than previously considered in women during pregnancy and the postpartum, and are associated with adverse effects on the mother and her fetus. We determined the efficacy and accuracy of screening women for primary hypothyroidism and autoimmune thyroiditis by testing TSH and two thyroid antibodies (TAb): thyroperoxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb), in eluates of filter paper specimens collected during early pregnancy and the postpartum. We enrolled 494 first-trimester pregnant women with no exclusion criteria into a prospective study to detect primary hypothyroidism and autoimmune thyroiditis. Finger stick blood was applied to filter paper, dried in room air, eluted, and promptly tested for TSH and TAb. A total of 178 of the pregnant women (36%) were tested in the early postpartum. Women with abnormal results had confirmatory serum tests. It was found that 91 pregnant women (18.4%) and 43 postpartum women (24.2%) had abnormal TSH values (>4.0 mU/L) and/or positive TAb; 140 pregnant women (28.3%) had TSH values >2.5 mU/L. All subjects with TSH values >4.0 mU/L tested positive for TAb. Eighteen women (3.6%) who tested normal during pregnancy tested abnormal in the postpartum. This study confirms that TSH and TPOAb measured in eluates of blood-spotted filter paper specimens are excellent screening tests to detect primary hypothyroidism and autoimmune thyroiditis in pregnant and postpartum women. Results are very comparable to serum data in this population published in the literature.