Evaluation of Thyroid Dysfunction and Iodine Supplementation in Preconception and Pregnancy

Abstract

INTRODUCTION: Pregnancy represents a period of increased demand for thyroid hormones. Thyroid function evaluation is indicated during preconception/pregnancy, particularly if there is previous thyroid pathology or residence in a place with iodine deficiency. Iodine supplementation is safe in the presence of a normal value of thyroid stimulating hormone (TSH) and in the absence of thyroid pathology. Moreover, this evaluation allows early detection of thyroid dysfunction, minimizing the clinical risk in pregnancy. The aim of this study is to evaluate the performance in primary care regarding the evaluation of thyroid function, iodine supplementation and approach to thyroid pathology in pregnancy.
MATERIAL AND METHODS: This study was analytical, observational and cross-sectional. The sample consists of pregnant women followed in four primary health care units, whose children were born between February 2019 and January 2020.
RESULTS: Of the 264 pregnant women included, 34.8% had a preconception consultation. A percentage of 90.9% of the pregnant women had no history of thyroid pathology. The TSH was measured in 49.6% and it was prescribed iodine supplementation in 89.2%. Three cases of hypothyroidism and one of hyperthyroidism were diagnosed. Most of the pregnant women with previous pathology was referred to the hospital, except for one woman with goiter.
CONCLUSION: In primary care the approach to thyroid dysfuntion should be systematized and standardized given the particularities of, namely, iodine supplementation and hospital referral. Pre-conception consultation is essential in cases of previous known pathology. It would be desirable to have an updated national guideline to standardize procedures in this area.