Mehran L, Tohidi M, Sarvghadi F, Delshad H, Amouzegar A, Soldin O P, Azizi F
Endocrine Research Center, Research Institute for Endocrine Sciences, Shaheed Beheshti University of Medical Sciences, P.O. Box 19395-4763, Tehran, Iran.
J Thyroid Res. 2013;2013:542692. doi: 10.1155/2013/542692. Epub 2013 May 12.
The presence of thyroid autoantibodies is relatively high in women of childbearing age. There is evidence that positive thyroperoxidase antibody even in euthyroid women may increase the risk of spontaneous and recurrent pregnancy loss and preterm delivery. However, the evidence is not enough to justify recommendation on the screening of pregnant women for thyroid autoantibodies or LT4 supplementation for reducing maternal or fetal complications. In this paper we reviewed the related evidence and compared the new guidelines of the American Thyroid Association and Endocrine Society with respect to the screening and management of positive thyroperoxidase antibody in euthyroid pregnant women. As there was no major contradiction or disagreement between the two guidelines, either one of two guidelines may be used by clinicians for the appropriate management of thyroid autoimmunity during pregnancy.
育龄女性中甲状腺自身抗体的存在较为普遍。有证据表明，即使是甲状腺功能正常的女性，甲状腺过氧化物酶抗体呈阳性也可能增加自然流产、复发性流产和早产的风险。然而，这些证据不足以支持对孕妇进行甲状腺自身抗体筛查或补充左甲状腺素以减少母婴并发症的建议。在本文中，我们回顾了相关证据，并比较了美国甲状腺协会和内分泌学会关于甲状腺功能正常的孕妇甲状腺过氧化物酶抗体阳性的筛查和管理的新指南。由于这两个指南之间没有重大矛盾或分歧，临床医生可以使用其中任何一个指南来对孕期甲状腺自身免疫进行适当管理。
