Albayrak Mehmet, Yükcü Bekir
Perinatology Department, Giresun Obstetric and Pediatric Disease Education and Research Hospital, 28200 Giresun, Türkiye.
Pediatric Cardiology Department, Giresun Obstetric and Pediatric Disease Education and Research Hospital, 28200 Giresun, Türkiye.
Diagnostics (Basel). 2025 Jan 24;15(3):276. doi: 10.3390/diagnostics15030276.
: This study investigated the impact of maternal subclinical hypothyroidism on fetal thymus size and development and explored how inadequate thyroid hormone production in pregnant women affects the fetal thymus. : Conducted at the Giresun Obstetrics, Gynecology, and Pediatrics Training and Research Hospital, this case-control study involved 86 pregnant women, 43 with hypothyroidism and 43 without. Maternal thyroid function was assessed using TSH and free T4 levels, and fetal thymus size and thymus-thorax ratio were measured using ultrasound. Exclusion criteria were chronic hypertension, gestational hypertension or eclampsia, multiple pregnancies, infectious diseases, renovascular diseases, diagnosed with hypothyroidism prior to pregnancy and other endocrine disorders, fetal cardiac diseases, and morbid obesity. Data collected included maternal age, gestational week, number of pregnancies, parity, number of living children, thyroid-stimulating hormone (TSH) and Free thyroxine 4 (T4) levels, and fetal thymus measurements (transverse diameter and thymus/thorax ratio). Statistical analyses were performed using the Mann-Whitney U test and logistic regression analysis. The relationships between TSH, thymus diameters, thorax diameters, and the thymus-thorax ratio were evaluated using Spearman's correlation coefficient. : The thymus-thorax ratio was significantly reduced in the hypothyroid group ( = 0.003). Logistic regression analysis identified TSH as an independent risk factor for a low thymus-thorax ratio, with each unit increase in TSH associated with a 1.345-fold higher likelihood of having a low thymus-thorax ratio. A significant negative correlation was found between TSH levels and the TTR ratio (Spearman's correlation coefficient r = -0.338, = 0.001). : An association was identified between maternal TSH levels and the thymus-thorax ratio, with increasing TSH levels correlating with a decrease in the thymus-thorax ratio. Regular monitoring of thyroid hormone levels during pregnancy and appropriate replacement treatment in cases of deficiency are crucial for optimal fetal thymus development. Further multicenter studies are needed to confirm these findings and investigate the long-term implications of altered fetal thymus development.
本研究调查了孕妇亚临床甲状腺功能减退对胎儿胸腺大小和发育的影响，并探讨了孕妇甲状腺激素分泌不足如何影响胎儿胸腺。本病例对照研究在吉雷松妇产儿科培训与研究医院进行，涉及86名孕妇，其中43名患有甲状腺功能减退，43名未患。通过促甲状腺激素（TSH）和游离甲状腺素4（T4）水平评估孕妇甲状腺功能，使用超声测量胎儿胸腺大小和胸腺-胸廓比值。排除标准包括慢性高血压、妊娠期高血压或子痫、多胎妊娠、传染病、肾血管疾病、妊娠前诊断为甲状腺功能减退和其他内分泌疾病、胎儿心脏病以及病态肥胖。收集的数据包括孕妇年龄、孕周、妊娠次数、产次、存活子女数、促甲状腺激素（TSH）和游离甲状腺素4（T4）水平以及胎儿胸腺测量值（横径和胸腺/胸廓比值）。采用曼-惠特尼U检验和逻辑回归分析进行统计分析。使用斯皮尔曼相关系数评估TSH、胸腺直径、胸廓直径和胸腺-胸廓比值之间的关系。甲状腺功能减退组的胸腺-胸廓比值显著降低（P = 0.003）。逻辑回归分析确定TSH是胸腺-胸廓比值低的独立危险因素，TSH每增加一个单位，胸腺-胸廓比值低的可能性就高1.345倍。TSH水平与TTR比值之间存在显著负相关（斯皮尔曼相关系数r = -0.338，P = 0.001）。确定了孕妇TSH水平与胸腺-胸廓比值之间的关联，TSH水平升高与胸腺-胸廓比值降低相关。孕期定期监测甲状腺激素水平，在缺乏时进行适当的替代治疗，对胎儿胸腺的最佳发育至关重要。需要进一步的多中心研究来证实这些发现，并调查胎儿胸腺发育改变的长期影响。
