Rodrigo Valero A M, Herranz Antolín S, Bienvenido Villalba M, Cisneros Gutiérrez Del Olmo N
Servicio de Análisis Clínicos, Hospital Universitario de Guadalajara, Guadalajara, España.
Servicio de Endocrinología y Nutrición, Hospital Universitario de Guadalajara, Guadalajara, España.
Semergen. 2024 May-Jun;50(4):102172. doi: 10.1016/j.semerg.2023.102172. Epub 2023 Dec 30.
Thyroid dysfunction during gestation impacts on maternal-fetal health and may influence the neurocognitive development of the child. Thyroid physiology changes during pregnancy and requires the establishment of specific reference levels per trimester and for each population and method. The objectives of our study were to analyse thyroid function throughout pregnancy and to establish reference levels for TSH and T4L in each trimester for our population and methodology.
Prospective analytical study of 598 pregnant women from March 2018 to October 2020. TSH, T4L, T3L, ATPO and ATG were determined in all of them. A total of 151 pregnant women were excluded due to positive thyroid immunity, previous thyroid disease in treatment with levothyroxine, twin pregnancy, diagnosis of hypothyroidism and hyperthyroidism in the request or absence of some of the parameters studied, with a reference population of 447 pregnant women.
The reference levels for TSH were 0.07-3.14mIU/L for the first, 0.66-3.21mIU/L for the second and 0.52-2.97mIU/L for the third trimester. Reference levels for T4L were 0.81-1.19ng/dL for the first, 0.71-1.07ng/dL for the second and 0.69-1.06ng/dL for the third trimester.
The reference levels for TSH and T4L obtained in this study differ from those used for the general population, which may have led to misclassification errors and unnecessary treatment in pregnant women.
妊娠期甲状腺功能障碍会影响母婴健康，并可能影响儿童的神经认知发育。孕期甲状腺生理发生变化，需要针对每个孕期、每个群体和每种方法建立特定的参考水平。我们研究的目的是分析整个孕期的甲状腺功能，并为我们的群体和方法确定每个孕期促甲状腺激素（TSH）和总甲状腺素（T4L）的参考水平。
对2018年3月至2020年10月期间的598名孕妇进行前瞻性分析研究。测定了所有孕妇的TSH、T4L、三碘甲状腺原氨酸（T3L）、甲状腺过氧化物酶抗体（ATPO）和甲状腺球蛋白抗体（ATG）。共有151名孕妇因甲状腺免疫阳性、先前接受左甲状腺素治疗的甲状腺疾病、双胎妊娠、在申请时诊断为甲状腺功能减退和甲状腺功能亢进或缺乏某些研究参数而被排除，最终参考人群为447名孕妇。
TSH的参考水平在孕早期为0.07 - 3.14mIU/L，孕中期为0.66 - 3.21mIU/L，孕晚期为0.52 - 2.97mIU/L。T4L的参考水平在孕早期为0.81 - 1.19ng/dL，孕中期为0.71 - 1.07ng/dL，孕晚期为0.69 - 1.06ng/dL。
本研究中获得的TSH和T4L参考水平与一般人群使用的参考水平不同，这可能导致孕妇出现错误分类和不必要的治疗。
