孕期孕产妇甲状腺功能低下症的管理:一项丹麦区域研究
Karoline Schack1, Line Meyer Laustsen1, Randi Ziska Sørensen1
1Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark.
Clinical endocrinology
|May 5, 2025
概括
患有甲状腺功能低下症的孕妇经常接受甲状腺刺激激素 (TSH) 监测. 在怀孕早期,Levothyroxine (L-T4) 剂量调整很常见,但在晚期显著下降.
科学领域:
- 内分泌学 在内分泌学.
- 产科 产科 产科 产科 产科
- 生殖医学 生殖医学
背景情况:
- 甲状腺功能低下症需要在怀孕期间谨慎管理,以防止不良后果.
- 临床指南建议定期监测甲状腺功能,并适当调整治疗.
研究的目的:
- 评估怀孕妇女对低甲状腺症管理的临床建议的遵守情况.
- 评估甲状腺刺激激素 (TSH) 监测的频率和时间以及整个怀孕期间的Levothyroxine (L-T4) 剂量调整.
主要方法:
- 在丹麦北部地区 (2022-2024) 进行对妊娠中患有甲状腺功能低下症的孕妇的回顾性队列研究.
- 对TSH水平和L-T4治疗数据的医疗记录分析.
- 主要终点包括生物化学监测的频率和L-T4剂量调整.
主要成果:
- 研究了175名L-T4孕妇,每次怀孕中位数为7次TSH监测.
- 剂量调整发生在约50.6%的妇女在第12周,下降到21.3%在第24周,和10.3%在怀孕后期.
- 生物化学监测是频繁的,但剂量调整因妊娠期而异.
结论:
- 甲状腺功能的生化监测经常在患有甲状腺功能低下的孕妇中进行.
- 在怀孕早期,调整利沃甲氧氨酸 (L-T4) 剂量是常见的,但在后期更少.
- 研究结果表明,在怀孕期间优化甲状腺功能低下症管理方案的潜在领域.
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