Subclinical hypothyroidism and antithyroid autoantibodies in women with subfertility or recurrent pregnancy loss Scientific Impact Paper No. 70 June 2022
Subclinical hypothyroidism and antithyroid autoantibodies in women with subfertility or recurrent pregnancy loss Scientific Impact Paper No. 70 June 2022
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DOI：
10.1111/1471-0528.17187
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发表时间：
2022-06-28
影响因子：
5.8
通讯作者：
Coomarasamy，Arri
中科院分区：
文献类型：
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作者：
Dhillon-Smith，Rima K.;Boelaert，Kristien;Coomarasamy，Arri
甲状腺是位于颈部的腺体，对身体的许多过程都很重要。甲状腺问题在育龄妇女中很常见。为了成功怀孕，拥有一个正常工作的甲状腺是必不可少的。甲状腺最常见的问题之一是活动不足(称为甲状腺功能减退症)。一种早期的、轻度的甲状腺功能低下称为亚临床甲状腺功能减退症。通常情况下，患有这种疾病的人没有任何症状。另一个常见的问题是甲状腺自身免疫。在这里，免疫系统攻击甲状腺，有时会导致甲状腺功能异常。这可以通过血液中存在的称为抗体的蛋白质来诊断。轻微的甲状腺问题和高水平的甲状腺抗体的存在与流产和早产有关。医学界就是否应该在普通人群和试图要孩子的个人中进行甲状腺功能常规测试展开了辩论。此外，用于管理某些甲状腺问题的策略也受到了质疑。这篇科学影响论文利用最新的证据和指南，提供了有关甲状腺检测以及对有不孕症或反复流产病史的妇女的轻度甲状腺问题和甲状腺抗体的管理的信息。结论是，在亚临床甲状腺功能减退的情况下，用甲状腺素片(由甲状腺产生的激素)治疗这些妇女可能有一定的作用，并对治疗的截止水平提供了指导。
Plain language summaryThe thyroid is a gland located in the neck and is important for many processes in the body. Problems with the thyroid gland are common in women of reproductive age. It is essential to have a normal working thyroid gland in order to achieve a successful pregnancy. One of the most common problems with the thyroid is underactivity (known as hypothyroidism). An early, mild form of an underactive thyroid is called subclinical hypothyroidism. Often people with this condition do not have any symptoms. Another common problem is thyroid autoimmunity. Here, the immune system attacks the thyroid gland, sometimes leading to the development of abnormal thyroid function. This can be diagnosed by the presence of proteins in the bloodstream called antibodies.Mild thyroid problems and the presence of high levels of thyroid antibodies have been linked to miscarriage and premature birth. There is debate in medicine about whether there should be routine testing of thyroid function both in the general population and in individuals who are trying for a baby. In addition, the strategies used to manage certain thyroid problems are questioned. Discussions around testing and subsequent management particularly relate to women with a history of subfertility or repeated miscarriages.This Scientific Impact Paper provides information on thyroid testing and the management of mild thyroid problems and thyroid antibodies in women with a history of subfertility or recurrent miscarriages, using the latest evidence and guidelines. It concludes that there may be a role for treating these women with thyroxine tablets (the hormone produced by the thyroid gland) when subclinical hypothyroidism is present, and gives guidance on the cut‐off levels for treatment.