Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, Illinois 60612, USA.
Curr Opin Obstet Gynecol. 2013 Aug;25(4):267-73. doi: 10.1097/GCO.0b013e3283630d80.
It is unclear whether pregnancy outcomes are impacted by nonovert thyroid disease, and whether detection and treatment of abnormalities improve outcomes. Consequently, there is an ongoing debate regarding universal thyroid screening in pregnancy. A lack of solid evidence has prompted researchers to evaluate the role of screening and to examine pregnancy outcomes in women with thyroid dysfunction. In addition, as IVF has developed into a commonly used procedure, its impact on thyroid function has also been investigated. The most current literature on these topics will be summarized in this review.
The multiple societies that have published guidelines on thyroid disease in pregnancy have developed different recommendations, with none definitively advocating for universal screening at this time. However, recent studies examining the role of screening have supported it from an economic and prevalence standpoint. Despite this, evidence has failed to consistently demonstrate that treatment of nonovert thyroid disorders improves maternal and fetal outcomes. Recent research does suggest that close monitoring for and treatment of thyroid dysfunction is warranted in women undergoing IVF.
Further research must be performed to determine whether treatment of nonovert thyroid disease during pregnancy impacts outcomes. Concrete evidence will likely influence the universal screening debate.
目前尚不清楚甲状腺疾病是否会影响妊娠结局，以及检测和治疗异常是否能改善结局。因此，目前仍在争论是否应在妊娠期间进行常规甲状腺筛查。由于缺乏确凿的证据，研究人员一直在评估筛查的作用，并研究甲状腺功能障碍妇女的妊娠结局。此外，随着体外受精（IVF）技术的发展，其对甲状腺功能的影响也受到了关注。本综述将总结这些主题的最新文献。
已经发布妊娠期间甲状腺疾病指南的多个学会制定了不同的建议，目前均不明确支持进行常规筛查。然而，最近的研究从经济学和患病率的角度支持筛查的作用。尽管如此，证据并未一致表明治疗亚临床甲状腺疾病可改善母婴结局。最近的研究确实表明，在接受 IVF 的妇女中，密切监测和治疗甲状腺功能障碍是合理的。
必须进行进一步的研究，以确定妊娠期间治疗亚临床甲状腺疾病是否会影响结局。确凿的证据可能会影响常规筛查的争论。
