Perinatal significance of isolated maternal hypothyroxinemia identified in the first half of pregnancy
Perinatal significance of isolated maternal hypothyroxinemia identified in the first half of pregnancy
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DOI：
10.1097/01.aog.0000262054.03531.24
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发表时间：
2007-05-01
影响因子：
7.2
通讯作者：
Cunningham, Gary F.
中科院分区：
文献类型：
--
作者：
Casey, Brian M.;Dashe, Jodi S.;Cunningham, Gary F.
目的：建立妊娠特异的游离甲状腺素阈值，并评估妊娠早期发现的孤立的母体低甲状腺素血症对围产儿的影响。方法：对17298例妊娠早期曾接受促甲状腺激素(TSH)筛查的孕妇的血清标本进行游离甲状腺素(T-4)浓度和甲状腺过氧化物酶抗体检测。游离T-4低于0.86 ng/dL但TSH正常的妇女被确认为孤立的母体甲状腺激素减少症。将这些妇女的妊娠结局与TSH和游离T-4正常的妇女进行比较。分析这些妇女和亚临床甲状腺功能减退症妇女的甲状腺过氧化物酶抗体状况及其与游离T-4的关系。结果：233例妇女(1.3%)存在孤立的母体低甲状腺素血症。这些妇女中没有任何过度的不良妊娠结局。甲状腺过氧化物酶抗体阳性(>50国际单位/毫升)在正常妇女(4%)和单纯甲状腺功能减退症妇女(5%)中相似，但在亚临床甲状腺功能减退症妇女中更高(31%，P
OBJECTIVE: To establish pregnancy-specific free thyroxine thresholds and to assess perinatal effects associated with isolated maternal hypothyroxinemia identified in the first half of pregnancy.METHODS: Stored serum samples from 17,298 women who previously underwent thyroid-stimulating hormone (TSH) screening in the first half of pregnancy were analyzed for free thyroxine (T-4) concentrations and thyroid peroxidase antibodies. Women with a free T-4 below 0.86 ng/dL but a normal-range TSH were identified to have isolated maternal hypothyroxinemia. Pregnancy outcomes in these women were compared to those with a normal TSH and free T-4. Thyroid peroxidase antibody status and the relationship between TSH and free T-4 were analyzed for these women and women with subclinical hypothyroidism.RESULTS: Isolated maternal hypothyroxinemia was identified in 233 women (1.3%). There were not any excessive adverse pregnancy outcomes in these women. Positive thyroid peroxidase antibody assays (greater than 50 international units/mL) were similar in normal women (4%) and those with isolated hypothyroxinemia (5%) but were greater in women with subclinical hypothyroidism (31%, P