Groer Maureen W, Vaughan Jessica H
College of Nursing, University of South Florida, Tampa, FL 33612, USA.
J Obstet Gynecol Neonatal Nurs. 2013 Jan-Feb;42(1):E26-32. doi: 10.1111/j.1552-6909.2012.01425.x. Epub 2012 Nov 20.
To examine general dysphoric moods prospectively in women who tested positive for thyroid peroxidase autoantibodies (TPO) during pregnancy and postpartum.
Longitudinal, correlational, two-group, observational study.
Perinatal clinics.
Six-hundred thirty-one (631) pregnant women.
Participants were screened for TPO antibodies, and 63 were TPO euthyroid positive. All were asked to continue into a 6-month postpartum follow-up and 47 agreed. A comparison group of TPO negative women (n = 72) was randomly selected for follow-up. Women were visited monthly for 6 months and a blood sample was obtained to measure thyroid stimulating hormone (TSH), a targeted physical exam was conducted, and a thyroid symptom checklist (Perceived Stress Scale) and the Profile of Mood States (POMS) checklist were completed.
Pregnant TPO-positive women had significantly higher depressive symptoms and were more likely to score higher than 20 on the POMS depression (POMS-D) scale than TPO-negative women. The TPO-positive women had significantly higher depression, anger, and total mood disturbance scores postpartum than TPO-negative women, regardless of development of postpartum thyroiditis (n = 25).
Our results suggest that the presence of TPO autoantibodies alone in euthyroid pregnant and postpartum women increases the possibility of negative dysphoric moods, especially depressive symptoms that cannot be explained by stress or demographic factors.
前瞻性研究孕期及产后甲状腺过氧化物酶自身抗体(TPO)检测呈阳性的女性的一般烦躁情绪。
纵向、相关性、两组观察性研究。
围产期诊所。
631名孕妇。
对参与者进行TPO抗体筛查,63名甲状腺功能正常的TPO阳性者。所有参与者均被要求继续进行为期6个月的产后随访,47人同意。随机选择一组TPO阴性女性(n = 72)进行随访。在6个月内每月对女性进行访视,采集血样检测促甲状腺激素(TSH),进行针对性体格检查,并完成甲状腺症状清单(感知压力量表)和情绪状态剖面图(POMS)清单。
孕期TPO阳性女性的抑郁症状明显更严重,且在POMS抑郁量表(POMS-D)上得分高于20分的可能性高于TPO阴性女性。无论产后甲状腺炎(n = 25)的发生情况如何,TPO阳性女性产后的抑郁、愤怒和总情绪困扰得分均显著高于TPO阴性女性。
我们的结果表明,甲状腺功能正常的孕期及产后女性单独存在TPO自身抗体增加了出现负面烦躁情绪的可能性,尤其是无法用压力或人口统计学因素解释的抑郁症状。