Gárate-Escamilla Anna Karen, Garza-Padilla Edelmiro, Carvajal Rivera Agustín, Salas-Castro Celina, Andrès Emmanuel, Hajjam El Hassani Amir
NIT Lab, Univ. Bourgogne Franche-Comte, UTBM, F-90010 Belfort, France.
Monterrey Institute of Technology and Higher Education, Monterrey 64700, Mexico.
J Clin Med. 2020 Jul 15;9(7):2247. doi: 10.3390/jcm9072247.
Thyroid pathology is reported internationally in 5-10% of all pregnancies. The overall aim of this research was to determine the prevalence of hypothyroidism and risk factors during the first trimester screening in a Mexican patients sample. We included the records of 306 patients who attended a prenatal control consultation between January 2016 and December 2017 at the Women's Institute in Monterrey, Mexico. The studied sample had homogeneous demographic characteristics in terms of age, weight, height, BMI (body mass index) and number of pregnancies. The presence of at least one of the risk factors for thyroid disease was observed in 39.2% of the sample. Two and three clusters were identified, in which patients varied considerably among risk factors, symptoms and pregnancy complications. Compared to Cluster 0, one or more symptoms or signs of hypothyroidism occurred, while Cluster 1 was characterized by healthier patients. When three clusters were used, Cluster 2 had a higher TSH (thyroid stimulating hormone) value and pregnancy complications. There were no significant differences in perinatal variables. In addition, high TSH levels in first trimester pregnancy are characterized by pregnancy complications and decreased newborn weight. Our findings underline the high degree of disease heterogeneity with existing pregnant hypothyroid patients and the need to improve the phenotyping of the syndrome in the Mexican population.
甲状腺病理在全球所有妊娠中的报告发生率为5%-10%。本研究的总体目标是确定墨西哥患者样本在孕早期筛查期间甲状腺功能减退症的患病率及危险因素。我们纳入了2016年1月至2017年12月期间在墨西哥蒙特雷妇女研究所进行产前检查咨询的306例患者的记录。研究样本在年龄、体重、身高、体重指数(BMI)和妊娠次数方面具有相似的人口统计学特征。在39.2%的样本中观察到至少存在一种甲状腺疾病危险因素。识别出两个和三个聚类,其中患者在危险因素、症状和妊娠并发症方面差异很大。与聚类0相比,出现了一种或多种甲状腺功能减退的症状或体征,而聚类1的特点是患者更健康。当使用三个聚类时,聚类2的促甲状腺激素(TSH)值更高且有妊娠并发症。围产期变量无显著差异。此外,孕早期促甲状腺激素水平升高的特点是有妊娠并发症且新生儿体重降低。我们的研究结果强调了现有妊娠甲状腺功能减退患者疾病异质性程度高,以及在墨西哥人群中改善该综合征表型分型的必要性。