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

IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM Thyroid Research Pub Date : 2023-09-11 DOI:10.1186/s13044-023-00171-7
Georgiana Sitoris, Flora Veltri, Emna Jelloul, Pierre Kleynen, Serge Rozenberg, Kris G Poppe
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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。
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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.

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来源期刊
Thyroid Research
Thyroid Research Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
3.10
自引率
4.50%
发文量
21
审稿时长
8 weeks
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