Georgiana Sitoris, Flora Veltri, Emna Jelloul, Pierre Kleynen, Serge Rozenberg, Kris G Poppe
{"title":"甲状腺激素治疗对无TPOAb的亚临床甲状腺功能减退患者妊娠结局的影响:一项回顾性横断面研究","authors":"Georgiana Sitoris, Flora Veltri, Emna Jelloul, Pierre Kleynen, Serge Rozenberg, Kris G Poppe","doi":"10.1186/s13044-023-00171-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Evidence on the impact of thyroid hormone treatment (LT4) on maternal pregnancy outcomes in women with subclinical hypothyroidism (SCH) without thyroid peroxidase antibodies (TPOAb) positivity is scarce.</p><p><strong>Methods: </strong>Single centre, cross-sectional study in 1460 women screened for TSH, free T4 and TPOAb at median 13 (11-17) weeks of gestation during the period 2013-2014. Exclusion criteria were twin- and assisted reproduction pregnancies, TPO positivity, overt thyroid dysfunction, and treatment with LT4 before screening. The impact of LT4 on maternal pregnancy outcomes was investigated in a group of 53 women with SCH (TSH > 3.74 mIU/L) in which LT4 was initiated at median 13 (10-22) weeks (treated group). The control group included 18 women with SCH (TSH > 3.74 mIU/L). The prevalence of pregnancy complications in these two groups was compared with that in a euthyroid reference (REF) group of 1389 women (TSH ≤ 3.74 mIU/L).</p><p><strong>Results: </strong>The prevalence of pre-eclampsia and gestational diabetes (GDM) was higher in the control group vs the REF group (16.7% vs 5.0% and 27.8% vs 18.9%; p = 0.017 and p = 0.016, respectively), but comparable in the treated group vs the REF group (7.6% vs 5.0% and 22.6% vs 18.9%; p = 0.918 and 0.676, respectively). The prevalence of iron-deficiency anaemia was lower in the treated vs the REF group (17.0% vs 32.5%; p = 0.017).</p><p><strong>Conclusion: </strong>Pregnant women with untreated SCH and without TPOAb positivity had a higher prevalence of pre-eclampsia and GDM compared with euthyroid women, while this was not the case in women with treated SCH, even when it was initiated after the first trimester.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10494333/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of thyroid hormone treatment on maternal pregnancy outcomes in women with subclinical hypothyroidism without TPOAb: a retrospective cross-sectional study.\",\"authors\":\"Georgiana Sitoris, Flora Veltri, Emna Jelloul, Pierre Kleynen, Serge Rozenberg, Kris G Poppe\",\"doi\":\"10.1186/s13044-023-00171-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Evidence on the impact of thyroid hormone treatment (LT4) on maternal pregnancy outcomes in women with subclinical hypothyroidism (SCH) without thyroid peroxidase antibodies (TPOAb) positivity is scarce.</p><p><strong>Methods: </strong>Single centre, cross-sectional study in 1460 women screened for TSH, free T4 and TPOAb at median 13 (11-17) weeks of gestation during the period 2013-2014. Exclusion criteria were twin- and assisted reproduction pregnancies, TPO positivity, overt thyroid dysfunction, and treatment with LT4 before screening. The impact of LT4 on maternal pregnancy outcomes was investigated in a group of 53 women with SCH (TSH > 3.74 mIU/L) in which LT4 was initiated at median 13 (10-22) weeks (treated group). The control group included 18 women with SCH (TSH > 3.74 mIU/L). The prevalence of pregnancy complications in these two groups was compared with that in a euthyroid reference (REF) group of 1389 women (TSH ≤ 3.74 mIU/L).</p><p><strong>Results: </strong>The prevalence of pre-eclampsia and gestational diabetes (GDM) was higher in the control group vs the REF group (16.7% vs 5.0% and 27.8% vs 18.9%; p = 0.017 and p = 0.016, respectively), but comparable in the treated group vs the REF group (7.6% vs 5.0% and 22.6% vs 18.9%; p = 0.918 and 0.676, respectively). The prevalence of iron-deficiency anaemia was lower in the treated vs the REF group (17.0% vs 32.5%; p = 0.017).</p><p><strong>Conclusion: </strong>Pregnant women with untreated SCH and without TPOAb positivity had a higher prevalence of pre-eclampsia and GDM compared with euthyroid women, while this was not the case in women with treated SCH, even when it was initiated after the first trimester.</p>\",\"PeriodicalId\":39048,\"journal\":{\"name\":\"Thyroid Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2023-09-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10494333/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Thyroid Research\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s13044-023-00171-7\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Thyroid Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s13044-023-00171-7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
摘要
背景:甲状腺激素治疗(LT4)对无甲状腺过氧化物酶抗体(TPOAb)阳性的亚临床甲状腺功能减退(SCH)患者妊娠结局影响的证据很少。方法:对2013-2014年期间1460名中位妊娠13(11-17)周进行TSH、游离T4和TPOAb筛查的女性进行单中心横断面研究。排除标准为双胎和辅助生殖妊娠、TPO阳性、明显甲状腺功能障碍和筛查前接受LT4治疗。在一组53名SCH (TSH > 3.74 mIU/L)妇女中,研究了LT4对孕产妇妊娠结局的影响,其中LT4在中位13(10-22)周(治疗组)开始。对照组患者18例,TSH > 3.74 mIU/L。将两组妊娠并发症发生率与正常甲状腺参考(REF)组1389例(TSH≤3.74 mIU/L)进行比较。结果:对照组子痫前期和妊娠期糖尿病(GDM)患病率高于REF组(16.7% vs 5.0%, 27.8% vs 18.9%;p = 0.017和p = 0.016),但治疗组与REF组具有可比性(7.6% vs 5.0%和22.6% vs 18.9%;P = 0.918, 0.676)。治疗组缺铁性贫血的患病率低于REF组(17.0% vs 32.5%;p = 0.017)。结论:与甲状腺功能正常的孕妇相比,未经治疗的SCH和TPOAb阳性的孕妇有更高的先兆子痫和GDM的患病率,而接受治疗的SCH妇女则不是这种情况,即使在妊娠早期开始治疗也是如此。
Impact of thyroid hormone treatment on maternal pregnancy outcomes in women with subclinical hypothyroidism without TPOAb: a retrospective cross-sectional study.
Background: Evidence on the impact of thyroid hormone treatment (LT4) on maternal pregnancy outcomes in women with subclinical hypothyroidism (SCH) without thyroid peroxidase antibodies (TPOAb) positivity is scarce.
Methods: Single centre, cross-sectional study in 1460 women screened for TSH, free T4 and TPOAb at median 13 (11-17) weeks of gestation during the period 2013-2014. Exclusion criteria were twin- and assisted reproduction pregnancies, TPO positivity, overt thyroid dysfunction, and treatment with LT4 before screening. The impact of LT4 on maternal pregnancy outcomes was investigated in a group of 53 women with SCH (TSH > 3.74 mIU/L) in which LT4 was initiated at median 13 (10-22) weeks (treated group). The control group included 18 women with SCH (TSH > 3.74 mIU/L). The prevalence of pregnancy complications in these two groups was compared with that in a euthyroid reference (REF) group of 1389 women (TSH ≤ 3.74 mIU/L).
Results: The prevalence of pre-eclampsia and gestational diabetes (GDM) was higher in the control group vs the REF group (16.7% vs 5.0% and 27.8% vs 18.9%; p = 0.017 and p = 0.016, respectively), but comparable in the treated group vs the REF group (7.6% vs 5.0% and 22.6% vs 18.9%; p = 0.918 and 0.676, respectively). The prevalence of iron-deficiency anaemia was lower in the treated vs the REF group (17.0% vs 32.5%; p = 0.017).
Conclusion: Pregnant women with untreated SCH and without TPOAb positivity had a higher prevalence of pre-eclampsia and GDM compared with euthyroid women, while this was not the case in women with treated SCH, even when it was initiated after the first trimester.