Academic Center for Thyroid Diseases, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
Endocrinol Metab (Seoul). 2022 Jun;37(3):387-391. doi: 10.3803/EnM.2022.301. Epub 2022 Jun 29.
Thyroperoxidase antibody (TPOAb) positivity is a well-known risk factor for thyroid dysfunction during pregnancy and is associated with a suboptimal response to thyroidal stimulation by human chorionic gonadotropin. About 75% of TPOAb positive women are euthyroid and there seems to be a higher risk of predominantly miscarriage and preterm birth in this subgroup. Nonetheless, clinical decision making with regards to gestational levothyroxine treatment remains difficult due to a lack of large randomized trials. Future studies assessing dose-dependent associations and additional biomarkers that can distinguish low-risk from high-risk individuals will be key in disentangling the crude clinical data.
甲状腺过氧化物酶抗体 (TPOAb) 阳性是怀孕期间甲状腺功能障碍的已知危险因素，与人绒毛膜促性腺激素对甲状腺刺激的反应不佳有关。大约 75%的 TPOAb 阳性女性甲状腺功能正常，在这个亚组中，流产和早产的风险似乎更高。尽管如此，由于缺乏大规模随机试验，关于妊娠期左甲状腺素治疗的临床决策仍然困难。未来评估剂量依赖性关联和可以区分低风险和高风险个体的其他生物标志物的研究将是阐明原始临床数据的关键。
