双胞胎怀孕的第一季度甲状腺参考间隔:建立,诊断实用性和与不良结果的关联
Zhangli Dong1,2, Jianxia Lin1,2, Mi Han1,2
1Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
在怀孕早期为甲状腺刺激激素 (TSH) 和自由甲状腺素 (FT4) 建立双胞胎怀孕特定的甲状腺参考间隔,可以改善高风险怀孕的识别. 这些新的间隔提高了在双胞胎怀孕中检测甲状腺功能障碍的准确性.
科学领域:
- 内分泌学 在内分泌学.
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 生殖健康 生殖健康
背景情况:
- 怀孕期间甲状腺功能障碍会导致不良后果.
- 现有的甲状腺激素的参考间隔对于双胞胎怀孕可能不准确.
- 建立特定的间隔对于准确的诊断和管理至关重要.
研究的目的:
- 为了建立双胞胎怀孕的血清TSH和FT4早期怀孕的特定参考间隔.
- 评估这些双胞胎特异间隔的临床实用性.
- 评估甲状腺功能障碍与双胞胎不良妊娠结果之间的关联.
主要方法:
- 追溯分析了46,474个单独怀孕和1,183个双胞胎怀孕.
- 计算TSH和FT4的2.5至97.5百分位数,以建立参考间隔.
- 使用基平方和回归分析对甲状腺功能障碍异常检测率和患病率的比较.
主要成果:
- 双胞胎怀孕的中位数TSH较低,FT4比单胞胎更高.
- 双胞胎特异间隔降低了异常TSH/FT4检测率.
- 低TSH与孕前相关;低FT4与SGA,LGA,紧急剖腹产和胎儿痛苦相关.
结论:
- 怀孕早期双胞胎特异性甲状腺参考间隔可以提高高风险怀孕的识别.
- 这些间隔显示出临床应用在双胞胎怀孕管理中的重大潜力.
- 提高诊断准确度可以带来更好的孕产妇和胎儿的结果.
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