妊娠甲状腺疾病筛查
妊娠甲状腺疾病筛查方式包括所有妊娠妇女筛查和选择性筛查（Case-finding）。2011年ATA指南推荐后者。一些专家提出不同意见。英国学者Vaidya前瞻性观察1 560例妊娠妇女，平均初访时间在妊娠第9周，测定TSH、FT4和FT3。将观察妇女分为高危险组和非高危险组进行比较。发现血清TSH升高孕妇40例，其中12例（30%）不在“Case-finding”提出的范围内。中国医科大学妊娠与甲状腺疾病课题组前瞻性随访2 899例妊娠妇女，平均初访时间为妊娠第6周，测定TSH、FT4和甲状腺抗体。按指南标准将妊娠妇女分为高危险组和非高危险组，发现血清TSH升高孕妇123例，其中53例（43%）不在高危险组，也就是说仅在高危人群中筛查患有甲状腺疾病的妊娠妇女将会漏掉43%的患者。
2016年ATA指南仍然不支持在所有妊娠妇女筛查，他们认为无足够的循证医学证据支持。指南提出了选择性筛查的12项适应证：① 甲亢或者甲减病史或者临床症状。② 甲状腺抗体阳性或者甲状腺肿。③ 颈部放射治疗史或者甲状腺手术治疗。④年龄＜30岁。⑤ 1型糖尿病。⑥ 流产、早产、不育史。⑦ 多次妊娠（超过2次）。⑧ 甲状腺疾病家族史。⑨ 肥胖（BMI＞40kg/m2）。⑩ 服用胺碘酮、锂制剂，近期接受照影剂检查。
居住于中重度碘缺乏地区。
接受辅助生殖治疗。
我国的国情是：①父母和家庭对后代智力的期望值和对筛查的接受程度甚高。②女性生殖年龄推迟，高龄妊娠增加。③二胎政策实施，多胎是危险因素之一。④国家开展对农村结婚妇女实行免费身体检查（简称孕优项目）已经8年，其中包括TSH检查。⑤目前报告的亚临床甲减、低T4血症、TPOAb阳性的患病率占妊娠妇女的20%以上。所以我国开展对孕妇的筛查条件已经具备，筛查的指标是血清TSH、FT4和TPOAb。开展孕前妇女的筛查更为必要，纠正甲功后再行怀孕是最合理的措施。
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