Background: There are currently no guidelines for screening for thyroid peroxidase antibodies (TPOAb) during pregnancy. Currently, there is some debate as to whether pregnant women should be screened for TPOAb, universally, or using a risk-based approach. In addition, there is conflicting evidence suggesting the implications of positive TPOAb testing during pregnancy and their effect on not only the pregnancy, but also the postpartum period and the fetus. Purpose: To determine whether TPOAb should be screened for during the first trimester of pregnancy; and if so, to determine if a risk-based approach or universal screening method is more appropriate. Results: Twenty-four studies were reviewed examining antepartum complications of positive TPOAb, postpartum complications of positive TPOAb, negative impact of TPOAb positivity on the fetus, cost effectiveness of screening for TPOAb during pregnancy, and risk factors identified for those more likely to have positive TPOAb levels. Conclusion: There are enough risks associated with having positive TPOAb during pregnancy that they should be universally screened for during the first trimester of pregnancy. If all pregnant women are not universally screened for, then a risk-based approach should be implemented. Implications for Research and Practice: Certified nurse-midwives should universally screen for TPOAb during pregnancy. They should also be aware of the costs of screening for TPOAb during pregnancy in their facility as well as which insurance covers the cost of these tests. They should also be aware of what to expect should complications arise in a pregnancy, postpartum, and fetal complications of a woman with positive TPOAb.
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Gross, M. M. (2017). Routine Screening for Thyroid Peroxidase Antibodies During Pregnancy: Universal Versus targeted [Masterʼs thesis, Bethel University]. Spark Repository. https://spark.bethel.edu/etd/246