母亲的过度甲状腺功能低下和妊娠并发症:来自全国跨部门研究的见解
Tamar Eshkoli1,2,3, Nitzan Burrack3,4, Adi Gordon-Irshai3,4
1Endocrinology Unit, Soroka University Medical Center, Beer-Sheva 84101, Israel.
Journal of clinical medicine
|August 14, 2025
概括
怀孕期间明显的甲状腺功能低下并没有显著增加诸如早产或低出生体重等不良结果. 这一发现表明,对于明显甲状腺功能低下的孕妇来说,个性化治疗决策是必要的.
科学领域:
- 产科和妇科 产科和妇科
- 内分泌学 在内分泌学.
- 生殖健康 生殖健康
背景情况:
- 怀孕期间的过度甲状腺功能低下与不良结果有关.
- 以前的研究表明,风险包括早产,低出生体重和胎儿神经认知发育受损.
研究的目的:
- 评估明显甲状腺功能低下症 (TSH ≥10 mIU/L) 的妇女的怀孕并发症.
- 为了比较明显的甲状腺功能下降怀孕和甲状腺功能下降控制之间的结果.
主要方法:
- 横截面研究分析了来自259,897例活产妊娠 (2013-2022) 的数据.
- 过度的甲状腺功能低下症定义为平均TSH≥10mIU/L;安甲状腺组的TSH<4mIU/L.
- 基于倾向分数的匹配用于比较611个明显的甲状腺功能低下妊娠与9125个无甲状腺控制,调整为共变量.
主要成果:
- 在孕产妇的年龄,种族,社会经济地位,试管婴儿,重复流产,糖尿病或吸烟方面没有显著差异.
- 过早分娩,子宫前,妊娠糖尿病,剖腹产和子宫内生长限制的发病率是相似的.
- 过度的甲状腺功能低下症与并发症增加无关,尽管灵敏度分析显示风险略高 (IRR 1.1).
结论:
- 过度的甲状腺功能低下症,当调整为混因素时,与不良妊娠结果的风险增加无关.
- 怀孕期间明显的甲状腺功能低下症的治疗决定应根据患者的因素进行个性化.
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