Rajput Rajesh, Goel Vasudha, Nanda Smiti, Rajput Meena, Seth Shashi
Department of Endocrinology and Medicine VI, Pt. B.D.S. PGIMS, Rohtak, Haryana, India.
Department of Obstetrics and Gynaecology, Pt. B.D.S. PGIMS, Rohtak, Haryana, India.
Indian J Endocrinol Metab. 2015 May-Jun;19(3):416-9. doi: 10.4103/2230-8210.152791.
Undetected and untreated thyroid disorders are associated with adverse maternal and fetal outcomes. There are limited data on the prevalence of newly diagnosed thyroid disease during pregnancy from India. Therefore, this study was designed to evaluate the prevalence of thyroid dysfunction, especially hypothyroidism during the first trimester of pregnancy.
The present cross-sectional study was conducted at Department of endocrinology and antenatal clinic in the Obstetrics and Gynecology Pt. B.D. Sharma PGIMS, Rohtak over a period of 1-year. The total sample population comprised of 461 pregnant women with uncomplicated intrauterine singleton pregnancies in the first trimester of gestation without any history of thyroid disease or intake of any thyroid medication. Morning blood samples from the participants were analyzed for thyroid function tests, which included FT3, FT4, thyroid-stimulating hormone (TSH) and anti-thyroid peroxidase antibodies (TPO).
A total of 461 women were enrolled for this study. Mean maternal age was 23.79 ± 3.47 years. Median gestational age was 8 weeks 5 days. The median FT3, FT4 and TSH were 3.3 pg/mL, 1.25 ng/dL, and 1.40 mIU/L, respectively. Anti-TPO was elevated in 128 (27.8%) pregnant women. 99 (21.5%) women had sub-clinical hypothyroidism and 39 (39.4%) among them were positive for anti-TPO (P ≤ 0.001). 2 (0.4%) of women had overt hyperthyroidism, whereas 15 (3.3%) of the women had sub-clinical hyperthyroidism.
Considering the immense impact that maternal thyroid dysfunction has on maternal and fetal outcomes, prompt identification of thyroid dysfunction and its timely treatment is essential. Thus, universal screening of pregnant women for thyroid dysfunction should be considered especially in a country like India due to the high prevalence of thyroid dysfunction.
未被发现和未治疗的甲状腺疾病与不良的母婴结局相关。来自印度的关于孕期新诊断甲状腺疾病患病率的数据有限。因此,本研究旨在评估甲状腺功能障碍的患病率,尤其是妊娠早期的甲状腺功能减退症。
本横断面研究在罗塔克市Pt. B.D. 夏尔马研究生医学科学研究所妇产科的内分泌科和产前诊所进行,为期1年。总样本量包括461名妊娠早期单胎宫内妊娠且无甲状腺疾病史或未服用任何甲状腺药物的孕妇。对参与者的晨起血样进行甲状腺功能测试分析,包括游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)和抗甲状腺过氧化物酶抗体(TPO)。
本研究共纳入461名女性。孕妇平均年龄为23.79 ± 3.47岁。中位孕周为8周5天。FT3、FT4和TSH的中位数分别为3.3 pg/mL、1.25 ng/dL和1.40 mIU/L。128名(27.8%)孕妇的抗TPO升高。99名(21.5%)女性患有亚临床甲状腺功能减退症,其中39名(39.4%)抗TPO呈阳性(P≤0.001)。2名(0.4%)女性患有显性甲状腺功能亢进症,而15名(3.3%)女性患有亚临床甲状腺功能亢进症。
鉴于母体甲状腺功能障碍对母婴结局有巨大影响,及时识别甲状腺功能障碍并及时治疗至关重要。因此,应考虑对孕妇进行甲状腺功能障碍的普遍筛查,尤其是在像印度这样甲状腺功能障碍患病率较高的国家。