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Hypothyroidism and isolated hypothyroxinemia in pregnancy, from physiology to the clinic.孕期甲状腺功能减退症和单纯低甲状腺素血症:从生理到临床
Taiwan J Obstet Gynecol. 2019 Nov;58(6):757-763. doi: 10.1016/j.tjog.2019.09.005.
2
Association of Thyroid Function Test Abnormalities and Thyroid Autoimmunity With Preterm Birth: A Systematic Review and Meta-analysis.甲状腺功能测试异常和甲状腺自身免疫与早产的关联:系统评价和荟萃分析。
JAMA. 2019 Aug 20;322(7):632-641. doi: 10.1001/jama.2019.10931.
3
The impact of isolated maternal hypothyroxinemia during the first and second trimester of gestation on pregnancy outcomes: an intervention and prospective cohort study in China.孤立性母体妊娠早期和中期甲状腺素血症对妊娠结局的影响:在中国的一项干预和前瞻性队列研究。
J Endocrinol Invest. 2019 May;42(5):599-607. doi: 10.1007/s40618-018-0960-7. Epub 2018 Oct 17.
4
Maternal hypothyroxinemia in the first trimester of gestation and association with obstetric and neonatal outcomes and iron deficiency: a prospective Brazilian study.孕期头三个月母体甲状腺素水平低下及其与产科和新生儿结局以及缺铁的关联:一项巴西前瞻性研究。
Arch Endocrinol Metab. 2018 Jun;62(3):332-336. doi: 10.20945/2359-3997000000043. Epub 2018 May 17.
5
Associations of maternal iodine status and thyroid function with adverse pregnancy outcomes in Henan Province of China.中国河南省孕妇碘营养和甲状腺功能与不良妊娠结局的关系。
J Trace Elem Med Biol. 2018 May;47:104-110. doi: 10.1016/j.jtemb.2018.01.013. Epub 2018 Feb 2.
6
Higher levels of thyrotropin in pregnancy and adverse pregnancy outcomes.孕期促甲状腺激素水平升高与不良妊娠结局
J Matern Fetal Neonatal Med. 2019 Sep;32(17):2883-2888. doi: 10.1080/14767058.2018.1451509. Epub 2018 Mar 26.
7
2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum.美国甲状腺协会2017年妊娠期及产后甲状腺疾病诊断和管理指南。
Thyroid. 2017 Mar;27(3):315-389. doi: 10.1089/thy.2016.0457.
8
Maternal thyroid dysfunction during gestation, preterm delivery, and birthweight. The Infancia y Medio Ambiente Cohort, Spain.孕期母亲甲状腺功能障碍、早产与出生体重。西班牙婴幼儿与环境队列研究
Paediatr Perinat Epidemiol. 2015 Mar;29(2):113-22. doi: 10.1111/ppe.12172. Epub 2015 Jan 7.
9
Update on a new controversy in endocrinology: isolated maternal hypothyroxinemia.内分泌学新争议的最新进展:孤立性母体甲状腺素血症。
J Endocrinol Invest. 2015 Feb;38(2):117-23. doi: 10.1007/s40618-014-0203-5. Epub 2014 Nov 5.
10
Effects of subclinical hypothyroidism on maternal and perinatal outcomes during pregnancy: a single-center cohort study of a Chinese population.亚临床甲状腺功能减退对孕期母婴及围产期结局的影响:一项中国人群的单中心队列研究
PLoS One. 2014 Oct 29;9(10):e109364. doi: 10.1371/journal.pone.0109364. eCollection 2014.

单纯性甲状腺素血症对妊娠前半期(妊娠 1 至 2 期)妊娠结局无显著影响。

Insignificant Effect of Isolated Hypothyroxinemia on Pregnancy Outcomes During the First and Second Trimester of Pregnancy.

机构信息

Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

Department of Endocrinology, Third Affiliated Hospital of Wenzhou Medical University, Ruian, China.

出版信息

Front Endocrinol (Lausanne). 2020 Oct 16;11:528146. doi: 10.3389/fendo.2020.528146. eCollection 2020.

DOI:10.3389/fendo.2020.528146
PMID:33178133
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7596376/
Abstract

Adverse maternal outcomes and perinatal complications are associated with overt and subclinical maternal hypothyroidism. It is not clear whether these complications also occur in women with isolated hypothyroxinemia during pregnancy. The aim of this study was to evaluate the effects of isolated hypothyroxinemia on maternal and perinatal outcomes during pregnancy. This study included data from 2,864 pregnant women in the first trimester (67 women with isolated hypothyroxinemia, 784 euthyroid women) and the second trimester (70 women with isolated hypothyroxinemia, 1,943 euthyroid women) of pregnancy. Maternal serum samples were collected in the first and second trimesters to examine thyroid hormone concentration. Hypothyroxinemia was defined as a normal maternal thyroid-stimulating hormone concentration with a low maternal free thyroxine concentration and negative thyroid autoantibodies. The following maternal outcomes were recorded: gestational hypertension, gestational diabetes mellitus, placenta previa, placental abruption, prelabor rupture of membranes, and premature delivery. Perinatal outcomes, including fetal growth restriction, fetal distress, low birth weight, intrauterine fetal death, and malformation. The incidence of adverse pregnancy outcomes and perinatal complications was compared between women in the first trimester and second trimester with isolated hypothyroxinemia. There were no significant differences in the incidence rates of adverse maternal outcomes and perinatal complications between patients in the first and second trimesters with isolated hypothyroxinemia. The results of this study indicate that isolated hypothyroidism does not increase the incidence of adverse maternal outcomes and perinatal complications.

摘要

母体不良结局和围产儿并发症与显性和亚临床型母体甲状腺功能减退症相关。但目前尚不清楚孤立性妊娠期间甲状腺素血症患者是否也会出现这些并发症。本研究旨在评估孤立性妊娠期间甲状腺素血症对母体和围产儿结局的影响。

该研究纳入了 2864 名孕早期(67 名孤立性甲状腺素血症患者,784 名甲状腺功能正常患者)和孕中期(70 名孤立性甲状腺素血症患者,1943 名甲状腺功能正常患者)的孕妇数据。在孕早期和孕中期采集母体血清样本,以检测甲状腺激素浓度。孤立性甲状腺素血症定义为正常的母体促甲状腺激素浓度,伴低母体游离甲状腺素浓度和阴性甲状腺自身抗体。记录以下母体结局:妊娠期高血压、妊娠期糖尿病、前置胎盘、胎盘早剥、胎膜早破和早产。围产儿结局包括胎儿生长受限、胎儿窘迫、低出生体重儿、宫内胎儿死亡和畸形。比较孕早期和孕中期孤立性甲状腺素血症患者的不良妊娠结局和围产儿并发症发生率。

孤立性甲状腺素血症患者在孕早期和孕中期的不良母体结局和围产儿并发症发生率无显著差异。

本研究结果表明,孤立性甲状腺素血症不会增加不良母体结局和围产儿并发症的发生率。