Department of Endocrinology and Metabolic Diseases, Cardiovascular and Metabolic Unit, CHU Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex, France.
Ann Endocrinol (Paris). 2022 Aug;83(4):226-231. doi: 10.1016/j.ando.2022.01.006. Epub 2022 Feb 7.
Pregnancy can be complicated by hyperthyroidism or thyrotoxicosis. Diagnosis is founded on an increase in free thyroid hormones and low TSH. The most frequent etiologies are Graves' disease, an autoimmune disease linked to stimulatory anti-TSH receptor antibodies, and non-autoimmune gestational hyperthyroidism linked to the TSH-like activity of the chorionic growth hormone (hCG). During pregnancy, thyrotoxicosis can entail maternal, obstetrical and fetal or neonatal complications. Graves' hyperthyroidism may be responsible for fetal and neonatal hyperthyroidism due to placental transfer of stimulatory anti-TSH receptor antibodies. During pregnancy, treatment of thyrotoxicosis must restore normal thyroid function in the mother without affecting fetal thyroid function. The recent reassessment of the prevalence of teratogenic effects in children of women treated with antithyroid drugs in the first weeks of gestation should orient the care pathway before and during pregnancy for women of child-bearing age with hyperthyroidism linked to Graves' disease.
妊娠可并发甲状腺功能亢进症或甲亢。诊断基于游离甲状腺激素增加和 TSH 降低。最常见的病因是 Graves 病，这是一种与刺激 TSH 受体抗体相关的自身免疫性疾病，以及与绒毛膜生长激素（hCG）的 TSH 样活性相关的非自身免疫性妊娠甲亢。妊娠期间，甲亢可能导致母体、产科和胎儿或新生儿并发症。Graves 病引起的刺激性抗 TSH 受体抗体胎盘转移可能导致胎儿和新生儿甲亢。妊娠期间，甲亢的治疗必须在不影响胎儿甲状腺功能的情况下恢复母亲的正常甲状腺功能。最近对妊娠前和妊娠期间 Graves 病相关甲亢女性使用抗甲状腺药物治疗对胎儿致畸作用的普遍性进行了重新评估，这应指导育龄期女性的治疗途径。
