Department of Obstetrics, Women's Hospital School of Medicine Zhejiang University, Hangzhou, China.
Bioengineered. 2021 Dec;12(1):4183-4190. doi: 10.1080/21655979.2021.1955589.
To reassess the efficacy of levothyroxine on subclinical hypothyroidism (SCH, 4.0 mIU/L ≤ TSH (thyroid stimulating hormone) <10 mIU/L with normal free T4) during pregnancy. 165 levothyroxine-treated pregnant women experiencing SCH were screened. And controls were randomly selected using euthyroidism (EU) women, matched by age, gravidity, and parity in the EU group ( = 660). We evaluated laboratory characteristics and pregnancy outcomes during follow-ups. Compared with the EU group, the SCH group displayed higher inadequate maternal gestational weight gain, premature delivery, low birth weight offspring and infant offspring small for their gestational age. After levothyroxine treatment, the SCH group displayed lower total cholesterol, low-density lipoprotein levels, and higher serum homocysteine levels before delivery. Pregnant women with SCH still exhibit adverse pregnancy outcomes after levothyroxine treatment. Taken together, we believe that besides levothyroxine, vitamin B12 and folic acid could be added to the treatment of pregnant women with SCH. In addition, regular monitoring of blood sugar levels, lipid and homocysteine levels, and intervention gestational weight gain could alleviate the adverse effects of SCH on pregnancy outcomes.
重新评估左旋甲状腺素治疗妊娠期亚临床甲状腺功能减退症（SCH，4.0 mIU/L≤TSH（促甲状腺激素）<10 mIU/L，游离 T4 正常）的疗效。筛选了 165 例接受左旋甲状腺素治疗的 SCH 孕妇，并使用 EU 组中年龄、孕次和产次相匹配的甲状腺功能正常（EU）妇女随机选择对照组（=660）。我们在随访期间评估了实验室特征和妊娠结局。与 EU 组相比，SCH 组产妇妊娠体重增加不足、早产、低出生体重儿和婴儿小于胎龄儿的发生率更高。经左旋甲状腺素治疗后，SCH 组产妇分娩前总胆固醇和低密度脂蛋白水平降低，血清同型半胱氨酸水平升高。SCH 孕妇经左旋甲状腺素治疗后仍存在不良妊娠结局。综上所述，我们认为除了左旋甲状腺素外，维生素 B12 和叶酸也可用于治疗 SCH 孕妇。此外，定期监测血糖、血脂和同型半胱氨酸水平，并干预妊娠体重增加，可以减轻 SCH 对妊娠结局的不良影响。
