Table 3.

SWOT analysis

Strengths	Weaknesses
The first evidence-based review on the best screening method for thyroid dysfunction during preconception and pregnancy since the publication of ATA guidelines; Extensive selection of publications, with restricted criteria; exclusion of pregnant women with conditions that may lead to thyroid dysfunction; Topic of great interest, prevalence and impact on the population health, so concrete response is needed; Analysis of the major key points of discussion of both screening methods; Practical recommendations and perspective of a country.	Problem of taking robust conclusions due to weak or lacking evidence; TSH assessment without TPOAb do not differ the need of treatment in some cases of subclinical hypothyroidism.
Opportunities	Threats
Given there is no strong recommendation force for the decision on the best screening method, this study highlights the need for an individualized evaluation and future randomized controlled trials to reach a high level of evidence data to guide clinical practice.	Limited number of studies and their lack of high- quality data do not allow to draw firm conclusions. Uncertainty of TSH reference range in pregnancy and if levothyroxine treatment can improve outcomes.