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甲状腺激素水平升高是否会增加流产的风险:是还是不是?
Tatjana Barišić1, Marjana Jerković Raguž2, Ivona Šušak1
1Department of Obstetrics and Gynecology, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina.
怀孕早期甲状腺激素 (TSH) 水平升高与更高的流产风险有关. 孕产妇的甲状腺功能障碍,以高的TSH为标志,会对围产期的结果产生负面影响.
科学领域:
- 内分泌学 在内分泌学.
- 生殖医学 生殖医学
- 产科 产科 产科 产科 产科
背景情况:
- 甲状腺功能障碍在怀孕期间越来越令人担忧.
- 提升的甲状腺激素 (TSH) 水平可能与不良妊娠结果有关.
- 调查TSH与流产频率之间的相关性对于母亲健康至关重要.
研究的目的:
- 检查提升的甲状腺激素 (TSH) 水平和流产的频率之间的相关性.
- 评估在有流产史的妇女中亚临床甲状腺功能障碍的患病率.
- 确定影响流产的风险因素,包括TSH水平和体重指数 (BMI).
主要方法:
- 一项涉及380名孕妇的横截面研究.
- 在经历流产的妇女 (N=179) 和正常怀孕的妇女 (N=201) 中测量TSH,抗TPO抗体和FT4.
- 后勤多变量回归分析以确定TSH和BMI对流产风险的影响.
主要成果:
- 亚临床甲状腺功能低下的发生率在流产组 (61.4%) 与对照组 (15.79%) 相比显著更高.
- 在流产组 (4.31 ± 2.55 mIU/L) 与对照组 (1.95 ± 0.86 mIU/L) 的平均TSH水平显著更高.
- 提升的TSH (OR 1.47) 和BMI (OR 1.14) 是流产的重要预测因素. 甲状腺自身免疫和TSH>2.5mIU/L的组合增加了流产风险到65.75%.
结论:
- 怀孕早期的TSH水平较高与肥胖有关,可能表明母亲的甲状腺功能障碍.
- 在头三个月内保持最佳的甲状腺功能对于积极的围产期结果至关重要.
- 在怀孕期间早期发现和治疗甲状腺功能障碍对于降低流产率至关重要.
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