Zhou Min, Wang Min, Li Juming, Luo Xiaohui, Lei Minxiang
Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China.
Department of Endocrinology, Tianjin Fifth Central Hospital, Tianjin 300450, P.R. China.
Exp Ther Med. 2019 Sep;18(3):1807-1815. doi: 10.3892/etm.2019.7739. Epub 2019 Jul 5.
The current study aimed to analyze the effects of thyroid diseases on pregnancy outcomes and investigate the effects of levothyroxine (L-T4) tablets in the treatment of hypothyroidism. The current study determined the prevalence of thyroid diseases using two diagnostic criteria, the prevalence of thyroid diseases among pregnant women recruited in 2010 and 2014 were initially determined by the 2011 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and Postpartum (2011 ATA Guidelines). Subjects were categorized into six groups: Normal, hypothyroxinemia, hypothyroidism, subclinical hypothyroidism (SCH), hyperthyroidism and subclinical hyperthyroidism. L-T4 was administered in the thyroid-insufficient groups and the prevalence rates of these categories were obtained using the diagnostic criteria from the 2011 ATA Guidelines and the 2012 Chinese Guidelines for the Diagnosis and Treatment of Thyroid Disease During Pregnancy and Postpartum (2012 Chinese Guidelines). The results of the current study demonstrated that the screening of thyroid function was significantly increased in 2014 (thyroid dysfunction rate, 82.4% vs. 29.1%; P<0.001). Hypothyroxinemia, hypothyroidism, SCH, hyperthyroidism and subclinical hyperthyroidism increased the likelihood of certain adverse outcomes and complications. L-T4 decreased the odds of gestational hypertension, premature birth and low birth weight or very low birth weight in the hypothyroidism group. A statistically significant difference was identified between thyroid disease incidences as determined by the 2011 ATA Guidelines 2012 Chinese Guidelines. In conclusion, abnormal thyroid levels increased the odds of adverse pregnancy outcomes, L-T4 administration improved pregnancy outcomes and the 2012 Chinese Guidelines may provide a better reference for Chinese pregnant women with subclinical hyperthyroidism.
本研究旨在分析甲状腺疾病对妊娠结局的影响，并探讨左甲状腺素（L-T4）片治疗甲状腺功能减退症的效果。本研究采用两种诊断标准确定甲状腺疾病的患病率，2010年和2014年招募的孕妇中甲状腺疾病的患病率最初根据美国甲状腺协会《孕期和产后甲状腺疾病诊断和管理指南（2011年ATA指南）》确定。受试者分为六组：正常、低甲状腺素血症、甲状腺功能减退症、亚临床甲状腺功能减退症（SCH）、甲状腺功能亢进症和亚临床甲状腺功能亢进症。对甲状腺功能不足的组给予L-T4，并根据2011年ATA指南和《孕期和产后甲状腺疾病诊断与治疗中国指南（2012年中国指南）》的诊断标准获得这些类别的患病率。本研究结果表明，2014年甲状腺功能筛查显著增加（甲状腺功能障碍率，82.4%对29.1%；P<0.001）。低甲状腺素血症、甲状腺功能减退症、SCH、甲状腺功能亢进症和亚临床甲状腺功能亢进症增加了某些不良结局和并发症的可能性。L-T4降低了甲状腺功能减退症组中妊娠期高血压、早产和低出生体重或极低出生体重的几率。根据2011年ATA指南和2012年中国指南确定的甲状腺疾病发病率之间存在统计学显著差异。总之，甲状腺水平异常增加了不良妊娠结局的几率，L-T4给药改善了妊娠结局，2012年中国指南可能为中国亚临床甲状腺功能亢进症孕妇提供更好的参考。
