Prenatal Testing of Thyroid Is Debated

by Ingfei Chen Copyright 2009 The New York Times Company
When women think about pregnancy, the thyroid gland is seldom the first thing that leaps to mind. Nestled in the neck, the gland makes hormones that govern metabolism, helping to regulate body weight, heart rate and a host of other factors.
But if the thyroid malfunctions, it can produce too little or too much of these hormones. During pregnancy those conditions, known as hypothyroidism and hyperthyroidism, respectively, may lead to miscarriage, premature birth and pre-eclampsia — and in the case of hypothyroidism, impaired intelligence in the child.
A decade and a half of research has now brought the cumulative evidence of these risks to a critical mass. Clinical guidelines call for vigilant monitoring and treatment of patients to keep thyroid reserves normal and to safely guide women through pregnancy and early motherhood.
But because thyroid problems can easily go undiagnosed, the hazards have also set off a debate over whether every woman who is pregnant or planning to be should have a blood test to check her thyroid. That test measures for thyroid-stimulating hormone, or T.S.H., which spurs the gland’s hormone production.
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