Thyroid Unit, Division of Endocrinology, Hypertension and Diabetes, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Curr Opin Endocrinol Diabetes Obes. 2011 Dec;18(6):389-94. doi: 10.1097/MED.0b013e32834cd3d7.
Thyroid disease is common during pregnancy. There are multiple alterations in maternal thyroid physiology, leading to an increased demand for thyroid hormone during gestation, that have significant implications for both maternal and fetal health. Importantly, pregnant reference ranges must be used for appropriate diagnosis and treatment of maternal hypothyroidism. There is currently broad interest in the maternal and fetal complications of hypothyroidism during pregnancy, with significant debate regarding the nuances of screening, despite universal agreement regarding the need for treatment.
Current literature has provided new evidence demonstrating maternal and fetal complications of hypothyroidism during pregnancy. There is evidence for improved outcomes with appropriate treatment of maternal hypothyroidism.
Although universal screening for hypothyroidism in pregnancy is currently controversial, it is increasingly apparent that maternal hypothyroidism can significantly affect both maternal and fetal health outcomes. Because of the ease and low risk of treatment, current recommendations emphasize appropriate case recognition and treatment to minimize the risk of unnecessary complications.
甲状腺疾病在妊娠期间很常见。母体甲状腺生理学发生多种改变，导致妊娠期间甲状腺激素需求增加，这对母体和胎儿健康都有重大影响。重要的是，必须使用妊娠参考范围来适当诊断和治疗母体甲状腺功能减退症。目前，人们广泛关注妊娠期间甲状腺功能减退症对母婴的并发症，尽管普遍认为需要治疗，但对于筛查的细节仍存在很大争议。
目前的文献提供了新的证据，表明妊娠期间甲状腺功能减退症会导致母婴并发症。有证据表明，适当治疗母体甲状腺功能减退症可以改善母婴结局。
尽管目前对妊娠期间甲状腺功能减退症的普遍筛查存在争议，但越来越明显的是，母体甲状腺功能减退症会显著影响母婴健康结局。由于治疗简单且风险低，目前的建议强调适当识别和治疗病例，以最大限度地减少不必要的并发症风险。
