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胎儿损失与过多的甲状腺激素暴露相关
João Anselmo1, Dingcai Cao, Theodore Karrison
1Endocrinology Unit, Hospital Divino Espírito Santo, Ponta Delgada, Azores-Portugal.
JAMA
|August 12, 2004
概括
抗甲状腺激素 (RTH) 的母亲经历了更高的流产率. 他们的未受影响的婴儿出生时体重较低,并抑制了TSH,这表明胎儿的甲状腺激素 (TH) 过量导致胎儿的甲状腺毒性.
科学领域:
- 内分泌学 在内分泌学.
- 生殖医学 生殖医学
- 遗传学 遗传学 是一个
背景情况:
- 孕产妇甲状腺疾病显著影响怀孕的结果.
- 研究胎儿激素毒性是具有挑战性的,因为直接胎儿激素评估是有限的.
- 对甲状腺激素 (RTH) 的抵抗提供了一个研究TH过量对胎儿影响的模型.
研究的目的:
- 研究甲状腺激素 (TH) 过度暴露对母亲携带RTH的胎儿的影响.
- 为了评估RTH母亲的怀孕结果,而RTH母亲的怀孕结果是其他类型的Euthyroid.
- 为了确定高的母体TH水平是否会导致胎儿甲状腺毒性.
主要方法:
- 对来自阿佐尔群岛的一家患有RTH的167个人的回顾性分析.
- 基因型定型证实了受影响个体TH受体β基因中的Arg243-->Gln突变.
- 在受影响的母亲,受影响的父亲和不受影响的亲属之间比较怀孕结果,出生体重和新生儿TSH水平.
主要成果:
- 与对照组相比,受影响的母亲的流产率 (22.9%) 显著高于受影响的母亲 (2.0%-4.4%).
- 出生于受影响母亲的未受影响婴儿出生时体重较低 (平均SD得分为-1.79),TSH水平无法检测.
- 受影响的母亲有更受影响的后代的趋势 (20受影响vs. 11不受影响).
结论:
- 患有RTH的母亲中流产率高可能会不成比例地影响未受影响的胎儿.
- 在RTH中过多的孕产妇TH水平会导致胎儿胆固醇毒性,由低出生体重和未受影响婴儿的TSH抑制证明.
- 这些发现表明甲状腺激素过量对胎儿发育的直接毒性影响.
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