部分甲状腺切除术后怀孕期间甲状腺功能测试与一般人群:全国性的回顾性队列
Raviv Allon1, Dor Atias2, Nofar Ben-Basat3
1Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel; Hebrew University, Hadassah Medical School, Jerusalem, Israel.
概括
有部分甲状腺切除病史的孕妇接受更频繁的甲状腺查,甲状腺刺激激素 (TSH) 的升高率更高. 这凸显了在怀孕期间需要改进,基于风险的甲状腺监测.
科学领域:
- 内分泌学 在内分泌学.
- 产科 产科 产科 产科 产科
- 公共卫生 公共卫生
背景情况:
- 在怀孕期间进行甲状腺功能查是有争议的,指南建议对高风险群体进行监测.
- 对于孕妇的查强度和随访协议存在变化.
研究的目的:
- 为了比较部分甲状腺切除术后的孕妇和一般孕妇之间的甲状腺功能监测频率和结果.
- 评估这些群体中妊娠性甲状腺功能低下症的发生率.
主要方法:
- 一项国家追溯匹配队列研究分析了2002-2023年的数据.
- 以往部分甲状腺切除术的妇女 (暴露组) 与没有 (非暴露组) 的妇女的怀孕情况进行比较.
- 主要结果:血清甲状腺刺激激素 (TSH) 测量频率;次要结果:妊娠性甲状腺功能低下症发生率.
主要成果:
- 81%的部分甲状腺切除术怀孕中测定了TSH,而一般人群中为62% (P < .01).
- 18%的部分甲状腺切除术怀孕在所有三季度进行了TSH测试,而3% (P < .01).
- 在部分甲状腺切除组中,提升的TSH患病率更高 (9%对4%,P<.01).
结论:
- 怀孕期间的甲状腺查仍然不理想.
- 部分甲状腺切除术后的孕妇接受更密集的监测,承认他们的高风险状态.
- 研究结果强调需要加强在怀孕期间基于风险的甲状腺监测的实施.
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