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妊娠 11-13 周时的母体甲状腺功能与自发性早产。

Maternal thyroid function at 11-13 weeks of gestation and spontaneous preterm delivery.

机构信息

From the Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK; the Department of Fetal Medicine, University College Hospital, London, UK; and Unidad Medicina Fetal, Centro Sanitario Virgen del Pilar, San Sebastián, Spain.

出版信息

Obstet Gynecol. 2011 Feb;117(2 Pt 1):293-298. doi: 10.1097/AOG.0b013e318205152c.

Abstract

OBJECTIVE

To estimate the possible association between spontaneous early preterm delivery and maternal thyroid dysfunction in early pregnancy.

METHODS

Maternal serum concentrations of thyroid-stimulating hormone (TSH), free thyroxine, antithyroperoxidase, and antithyroglobulin antibodies at 11-13 weeks of gestation were compared in 102 singleton pregnancies, resulting in spontaneous delivery before 34 weeks and 4,318 normal pregnancies delivering after this gestation.

RESULTS

In the preterm delivery group, compared with the normal outcome group, there was no significant difference in antithyroid antibody positivity (16.7% compared with 16.8%). In the antithyroid antibody-negative pregnancies in the preterm delivery group, compared with the normal outcome group, the median free thyroxine multiple of the median was reduced (0.94 compared with 0.99 multiple of the median, P<.001), but the median TSH multiple of the median was not significantly different (0.99 compared with 1.01 multiple of the median, P=.331).

CONCLUSION

In pregnancies resulting in spontaneous early preterm delivery, there is no evidence of increased prevalence of antithyroid antibody positivity or maternal thyroid dysfunction at 11-13 weeks.

LEVEL OF EVIDENCE

II.

摘要

目的

评估早孕期母体甲状腺功能障碍与自发性早产早期的可能关联。

方法

比较了 102 例单胎妊娠在 11-13 周妊娠时的血清促甲状腺激素(TSH)、游离甲状腺素、抗甲状腺过氧化物酶和抗甲状腺球蛋白抗体浓度,这些妊娠均自发性早产且发生在 34 周前,而 4318 例正常妊娠均在该孕周后分娩。

结果

与正常妊娠结局组相比,早产组的抗甲状腺抗体阳性率(16.7%比 16.8%)差异无统计学意义。在早产组的抗甲状腺抗体阴性妊娠中,与正常妊娠结局组相比,游离甲状腺素中位数倍数降低(0.94 比 0.99 中位数倍数,P<.001),但 TSH 中位数倍数差异无统计学意义(0.99 比 1.01 中位数倍数,P=.331)。

结论

自发性早产早期妊娠中,并无证据表明抗甲状腺抗体阳性率或早孕期母体甲状腺功能障碍的患病率增加。

证据水平

II 级。

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