Comparison of universal screening with targeted high-risk case finding for diagnosis of XXXX .

@entity1 @entity1375 @entity1955 @entity1378 @entity1374
OBJECTIVE: Debate about the need for universal screening of @entity1374 in pregnancy is ongoing. The present study aimed to compare universal screening with targeted high-risk case findings for early diagnosis of @entity1374 in Iranian pregnant @entity1 . STUDY DESIGN: This cross-sectional prospective study was carried out on 1600 pregnant @entity1 in their first trimester. A checklist, including all related risk factors recommended by The American Thyroid Association, was completed for all participants. Serum concentrations of @entity1955 (T4), T-uptake, thyrotropin (TSH) and thyroid peroxidase antibody (TPOAb) were measured and thyroid status was documented, based on hormonal measurements and clinical examinations. RESULTS: There were 656 @entity1 (44.3%) that had at least one risk factor for @entity1374 and were eligible for the targeted high-risk case finding (high-risk group) approach, while 55.7% had no risk factors (low-risk group). Using the universal screening approach, there were 974 @entity1 (65.8%) with normal thyroid status and 506 @entity1 (34.2%) with @entity1374 , including overt @entity1378 (0.7%), @entity1375 (1.1%), @entity1375 (30.1% ; positive TPOAb (5.5%) and negative TPOAb (24.6%) and euthyroid and positive TPOAb (2.3%). Of @entity1 with @entity1374 , 64.4% were in high-risk group and 35.6% were in low-risk group (P<0.0001). CONCLUSIONS: The targeted high-risk case finding approach overlooks about one-third of pregnant @entity1 with @entity1374 . If ongoing prospective trials provide evidence on the efficacy of treating @entity1375 in pregnancy, in populations with a low prevalence of presumed risk factors, the targeted high-risk case finding approach will be proven inefficient.
