Division of Endocrinology, "V. Fazzi" Hospital, Lecce, Italy.
Best Pract Res Clin Endocrinol Metab. 2011 Dec;25(6):927-43. doi: 10.1016/j.beem.2011.07.010.
Thyroid diseases are common in women of childbearing age and it is well known that untreated thyroid disturbances result in an increased rate of adverse events, particularly miscarriage, preterm birth and gestational hypertension. Furthermore, thyroid autoimmunity per se seems to be associated with complications such as miscarriage and preterm delivery. While strong evidence clearly demonstrates that overt dysfunctions (hyper- or hypothyroidism) have deleterious effects on pregnancy, subclinical disease, namely subclinical hypothyroidism, has still to be conclusively defined as a risk factor for adverse outcomes. Additionally, other conditions, such as isolated hypothyroxinemia and thyroid autoimmunity in euthyroidism, are still clouded with uncertainty regarding the need for substitutive treatment.
甲状腺疾病在育龄妇女中很常见,众所周知,未经治疗的甲状腺功能紊乱会导致不良事件发生率增加,特别是流产、早产和妊娠高血压。此外,甲状腺自身免疫本身似乎与流产和早产等并发症有关。虽然强有力的证据清楚地表明显性功能障碍(甲状腺功能亢进或减退)对妊娠有不良影响,但亚临床疾病,即亚临床甲状腺功能减退,仍有待明确界定为不良结局的危险因素。此外,其他情况,如单纯性甲状腺素血症和甲状腺功能正常的甲状腺自身免疫,对于是否需要替代治疗仍然存在不确定性。