甲状腺功能障碍的产前查:早产,低出生体重和生长限制
Ishraq Dhaifalah1,2, Jana Havalova3, Dagmar Langova3
1Fetal Medicine and Genetics Center, Olomouc and Ostrava, Czech Republic.
概括
孕产妇甲状腺查可以识别出患早产和低出生体重的风险较高的妇女. 无论甲状腺功能障碍或治疗如何,这些风险仍然存在,这表明过早分娩可能是导致因素.
科学领域:
- 产科和妇科 产科和妇科
- 内分泌学 在内分泌学.
- 围产儿医学 围产儿医学
背景情况:
- 怀孕期间母亲的甲状腺功能对胎儿发育至关重要.
- 怀孕早期的甲状腺查旨在识别可能影响结果的功能障碍.
- 甲状腺查结果与不良妊娠结果之间的关系需要进一步澄清.
研究的目的:
- 评估母体甲状腺查结果与早产,低出生体重和妊娠年龄相对小 (SGA) 婴儿的发病率之间的关联.
- 为了确定后续治疗是否会影响这些怀孕结果.
主要方法:
- 一项嵌套病例控制研究,涉及10,052名无症状的孕妇,她们在头三个月接受了查.
- 甲状腺查包括抗甲状腺过氧化酶抗体,甲状腺刺激激素和自由甲状腺素.
- 病例 (512) 的查结果呈阳性;对照 (1292) 的查结果呈阴性. 评估的结果是早产,低出生体重和SGA.
主要成果:
- 与对照组相比,呈阳性甲状腺查结果的妇女的早产 (RR 1.69) 和低出生体重 (RR 1.72) 的患病率显著更高.
- 低出生体重在满期怀孕中也增加,尽管在统计学上并不显著.
- 根据接受的治疗类型,在阳性病例中没有观察到早产或低出生体重率的显著差异.
结论:
- 阳性孕产妇甲状腺查结果与早产风险增加有关,这与甲状腺功能障碍或治疗无关.
- 与低出生体重的关联很可能是早产率增加的结果.
- 常规的甲状腺查可能有助于识别患有不良后果的怀孕,例如早产.
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