Kyrilli Aglaia, Unuane David, Poppe Kris G
Department of Endocrinology, Hôpital Erasme (Université Libre de Bruxelles, ULB), Route de Lennik, 808, 1070, Brussels, Belgium.
Department of Endocrinology, Universitair Ziekenhuis Brussel, UZ Brussel, (Vrije Universiteit Brussel, VUB), Laarbeeklaan, 101, 1090, Brussels, Belgium.
Best Pract Res Clin Endocrinol Metab. 2023 Mar;37(2):101632. doi: 10.1016/j.beem.2022.101632. Epub 2022 Feb 24.
Women with thyroid autoimmunity (TAI), predominately characterized by increased levels of thyroid peroxidase antibody (TPOAb), are at risk for developing pregnancy related complications. In this review, we discuss the importance of TAI during natal and perinatal stages. Before pregnancy, TAI is associated with higher mean serum TSH levels and certain causes of subfertility. During pregnancy, TAI increases the risk of an insufficient response of the thyroid to an increasing strain induced by pregnancy, and consequently (subclinical) hypothyroidism might develop. Euthyroid women with TAI have a higher rate of maternal and foetal complications, but it seems that causality cannot be pinned down to thyroid dysfunction alone. Almost half of the women known with TAI prior to pregnancy will also develop post-partum thyroiditis (PPT). However, any relation between PPT and post-partum depression remains uncertain. More research is required to explain possible associations between TAI and pregnancy morbidities, and studies should focus on a better understanding of TAI as such. Given the many unanswered questions, at present, it is not recommended to screen all (potentially) pregnant women for the presence of TAI.
甲状腺自身免疫（TAI）的女性，主要特征是甲状腺过氧化物酶抗体（TPOAb）水平升高，有发生与妊娠相关并发症的风险。在这篇综述中，我们讨论TAI在分娩期和围产期的重要性。怀孕前，TAI与较高的平均血清促甲状腺激素（TSH）水平以及某些不孕原因有关。怀孕期间，TAI会增加甲状腺对妊娠引起的压力增加反应不足的风险，因此可能会发展为（亚临床）甲状腺功能减退。甲状腺功能正常的TAI女性发生母婴并发症的几率更高，但似乎不能将因果关系仅仅归因于甲状腺功能障碍。几乎一半在怀孕前已知患有TAI的女性也会发生产后甲状腺炎（PPT）。然而，PPT与产后抑郁症之间的任何关系仍不确定。需要更多研究来解释TAI与妊娠疾病之间可能的关联，并且研究应专注于更好地了解TAI本身。鉴于有许多未解决的问题，目前不建议对所有（潜在）孕妇进行TAI筛查。
