Montoro M, Collea J V, Frasier S D, Mestman J H
Ann Intern Med. 1981 Jan;94(1):31-4. doi: 10.7326/0003-4819-94-1-31.
Published data on the influence of hypothyroidism on fertility, gestation, and the offspring are controversial. We studied nine hypothyroid women during 11 pregnancies. Mean serum values for thyroxine, triiodothyronine (T3), resin T3 uptake ratio, and thyroid-stimulating hormone were 2.3 microgram/dL, 82 ng/dL, 0.64, and 105 mU/mL, respectively. Four patients had iatrogenic hypothyroidism (three remote thyroidectomy, one remote 131I therapy), two Hashimoto's thyroiditis, and three idiopathic primary hypothyroidism. Seven patients first presented untreated after the 24th week of gestation. Two patients needed cesarean section; seven delivered vaginally. There was one stillborn infant in the only patient with pre-eclampsia. Another infant had Down's syndrome and an ostium primum defect (mother's age, 41 years). The remaining nine infants were normal at birth. All placentas were normal. Follow-up in seven infants up to 2.7 years showed normal thyroid function and somatic development. Infants of hypothyroid mothers may be normal because their hypothalamic-pituitary thyroid axis develops independently from the mother.
关于甲状腺功能减退对生育、妊娠及后代影响的已发表数据存在争议。我们对9名甲状腺功能减退女性的11次妊娠进行了研究。甲状腺素、三碘甲状腺原氨酸（T3）、树脂T3摄取率及促甲状腺激素的血清均值分别为2.3微克/分升、82纳克/分升、0.64及105毫国际单位/毫升。4例患者为医源性甲状腺功能减退（3例为远期甲状腺切除术，1例为远期放射性碘治疗），2例为桥本甲状腺炎，3例为特发性原发性甲状腺功能减退。7例患者在妊娠24周后首次就诊时未接受治疗。2例患者需要剖宫产；7例经阴道分娩。唯一患先兆子痫的患者产下一名死产婴儿。另一名婴儿患有唐氏综合征及原发孔缺损（母亲年龄41岁）。其余9名婴儿出生时正常。所有胎盘均正常。对7名婴儿随访至2.7岁，结果显示甲状腺功能及体格发育正常。甲状腺功能减退母亲的婴儿可能正常，因为其下丘脑 - 垂体 - 甲状腺轴独立于母亲发育。
