Keywords: hypothyroidism; maternal-fetal outcomes; obstetric outcomes; pregnancy; screening; thyroid function; universal EN hypothyroidism maternal-fetal outcomes obstetric outcomes pregnancy screening thyroid function universal 712 714 3 01/19/23 20230201 NES 230201 Thyroid disease is the second most common cause of endocrinopathy in pregnant women, affecting approximately 3%.[1] Maternal thyroid dysfunction (mainly overt hypothyroidism) can influence maternal-fetal health and cause obstetric complications.[2] However, whether or not to perform universal screening for thyroid dysfunction remains controversial, with no consensus between clinical practice guidelines.[3] The primary aim of our study was to evaluate the impact of universal screening implantation on adverse pregnancy outcomes in the setting of real-world clinical practice. No between-group differences were observed in baseline characteristics, except that first TSH and thyroid antibodies positivity (TPO-Ab) were significantly higher in the risk-based screening group than the universal screening group (TSH 1.98 vs. 1.69 mIU/L; I P i < 0.05; and TPO-Ab 72.4% vs. 23.7%; I P i < 0.05). Universal screening detected significantly higher rates of subclinical hypothyroidism and hyperthyroidism (TSH 4-10 mIU/L: 2.49% vs. 5.79%; TSH 2.5-4 mIU/L: 3.92% vs. 14.65%; TSH <0.1 mIU/L: 0.19% vs. 2.54%; I P i < 0.05), but the same number for overt hypothyroidism (1 vs. 1). [Extracted from the article]