Department of Neurology, Turku University Hospital, Finland.
Mult Scler. 2013 Nov;19(13):1734-42. doi: 10.1177/1352458513485148. Epub 2013 Apr 29.
Multiple sclerosis (MS) patients are predisposed to thyroid abnormalities, but the risk for pregnancy-related thyroid pathology among MS patients has not been evaluated.
The objectives of this research are to prospectively evaluate the prevalence of thyroid autoimmunity among MS patients in relation to pregnancy, and to investigate its impact on pregnancy outcome, postpartum depression and fatigue.
Forty-six pregnant MS patients underwent repeat testing for serum thyroid antibodies (Abs), clinical evaluation and thyroid hormone measurement. Results were compared to 35 age-matched healthy mothers.
At six months postpartum 35.3% of MS patients presented elevated levels of thyroid Abs compared to 5.7% of controls, p = 0.01. Mean thyroid Ab concentrations among MS patients were significantly reduced during pregnancy and returned to maximal levels at six months postpartum. The proportion of individuals with postpartum thyroid dysfunction did not differ significantly between MS patients and healthy controls (3.4% vs 2.9%, p = 1.00). Elevated thyroid Ab levels did not increase the risk for adverse pregnancy outcome, fatigue or postpartum depression.
Considering the tendency of MS mothers to develop thyroid autoimmunity postpartum and in association to treatments, we recommend screening MS patients for thyroid dysfunction (TSH) during early pregnancy and after delivery.
多发性硬化症（MS）患者易发生甲状腺异常，但 MS 患者妊娠相关甲状腺病理的风险尚未得到评估。
本研究旨在前瞻性评估 MS 患者妊娠时甲状腺自身免疫的患病率，并探讨其对妊娠结局、产后抑郁和疲劳的影响。
46 名妊娠 MS 患者接受了血清甲状腺抗体（Abs）、临床评估和甲状腺激素测量的重复检测。结果与 35 名年龄匹配的健康母亲进行了比较。
产后 6 个月时，35.3%的 MS 患者甲状腺 Abs 水平升高，而对照组为 5.7%，p = 0.01。MS 患者的甲状腺 Ab 浓度在妊娠期间显著降低，并在产后 6 个月时恢复至最高水平。MS 患者和健康对照组产后甲状腺功能障碍的比例无显著差异（3.4%对 2.9%，p = 1.00）。甲状腺 Ab 水平升高并不会增加不良妊娠结局、疲劳或产后抑郁的风险。
鉴于 MS 母亲产后及与治疗相关发生甲状腺自身免疫的倾向，我们建议在妊娠早期和分娩后对 MS 患者进行甲状腺功能减退（TSH）筛查。
