Akter F, Kamrul-Hasan A B, Ahmed E U, Selim S, Aalpona F Z, Emran M S, Alam M S, Saifuddin M, Hasanat M A, Fariduddin M
Dr Farhana Akter, Assistant Professor, Department of Endocrinology, Chittagong Medical College Hospital (CMCH), Chittagong, Bangladesh; E-mail:
Mymensingh Med J. 2018 Jul;27(3):603-609.
Study on thyroid function and thyroid autoantibody status in pregnancy considering the trimester specific range, is scarce in Bangladesh. This cross sectional study done in Bangabandhu Sheikh Mujib Medical University, Bangladesh from August 2012 to June 2013 encompassed 186 pregnant women of first trimester for study of thyroid function (TSH, FT₄) and anti-thyroid antibodies (anti-TPO, anti-TG). Age of the subjects was 25.4±4.9 years (mean±SD), median gestational age was 9 weeks. Applying the trimester-specific normal reference range set by American Thyroid Association (ATA), 48(25.8%) of the women were found to have thyroid dysfunction; 40(21.5%) subclinical hypothyroid (SCH), 1(0.5%) overt hypothyroid (OH) and 7(3.8%) hyperthyroid; 40(21.5%) women had goiter. If non-pregnant adult normal rage is used, 22 of SCH women as per ATA criteria will be labeled as normal and 19 normal women as per ATA cut off will be labeled as hyperthyroid. There was statistically significant disparity for functional status defined by these two references cut off value (p<0.001). 29(15.6%) women had thyroid autoimmunity and the autoantibody positivity was more frequent in women with thyroid dysfunction than euthyroid women (22.92% vs. 13.04%, p<0.001). Even though universal screening for thyroid dysfunction is not yet a recommendation, it should be considered in our population.
考虑到孕期特定范围,关于孟加拉国甲状腺功能和甲状腺自身抗体状态的研究稀缺。这项横断面研究于2012年8月至2013年6月在孟加拉国的班加班杜·谢赫·穆吉布医科大学开展,纳入了186名孕早期妇女,以研究甲状腺功能(促甲状腺激素、游离甲状腺素)和抗甲状腺抗体(抗甲状腺过氧化物酶抗体、抗甲状腺球蛋白抗体)。研究对象的年龄为25.4±4.9岁(均值±标准差),中位孕周为9周。采用美国甲状腺协会(ATA)设定的孕期特定正常参考范围,发现48名(25.8%)妇女存在甲状腺功能障碍;40名(21.5%)亚临床甲状腺功能减退(SCH),1名(0.5%)临床甲状腺功能减退(OH),7名(3.8%)甲状腺功能亢进;40名(21.5%)妇女有甲状腺肿。如果使用非孕期成人正常范围,按照ATA标准,22名SCH妇女将被标记为正常,而按照ATA临界值,19名正常妇女将被标记为甲状腺功能亢进。这两个参考临界值定义的功能状态存在统计学显著差异(p<0.001)。29名(15.6%)妇女存在甲状腺自身免疫,甲状腺功能障碍妇女的自身抗体阳性率高于甲状腺功能正常的妇女(22.92%对13.04%,p<0.001)。尽管尚未推荐对甲状腺功能障碍进行普遍筛查,但在我国人群中应予以考虑。