Thyroid (dys-)function in normal and disturbed pregnancy
Thyroid (dys-)function in normal and disturbed pregnancy
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DOI：
10.1007/s00404-012-2592-z
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发表时间：
2013-01-01
影响因子：
2.6
通讯作者：
Toth, Bettina
中科院分区：
文献类型：
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作者：
Budenhofer, Brigitte K.;Ditsch, Nina;Toth, Bettina
在怀孕期间，母体甲状腺功能发生生理变化，特别是由于激素和代谢过程。人绒毛膜促性腺激素激活母体甲状腺，导致甲状腺激素产生增加。充足的母体甲状腺激素对胎儿的发育至关重要，尤其是在妊娠的前三个月，此时胎儿甲状腺尚未发挥功能。目前对甲状腺功能障碍包括甲状腺自身免疫、甲状腺功能减退或甲状腺功能亢进的认识进行了总结，特别关注流产和妊娠疾病。因此，我们对Medline的一项关于甲状腺功能和妊娠的研究以及对现行指南的分析进行了研究，包括关注正常妊娠和异常妊娠的TSH水平、与甲状腺自身抗体相关的流产风险以及不孕和生育妇女的（亚临床）甲状腺功能减退。除了孕妇常规补碘和治疗甲状腺功能减退症和甲状腺功能亢进症外，还应在育龄妇女中常规测量TSH水平，并将浓度调整至< 2.5 mIU/l，以优化孕产妇健康和胎儿发育。
During pregnancy, physiologic changes in maternal thyroid function take place especially due to hormonal as well as metabolic processes. Human chorionic gonadotropin activates the maternal thyroid gland leading to increased thyroid hormone production. A sufficient availability of maternal thyroid hormones is essential for fetal development, especially during the first trimester of pregnancy, when the fetal thyroid gland is not yet functional.Current knowledge of thyroid dysfunction including thyroid autoimmunity, hypothyroidism or hyperthyroidism is summarized with special focus on miscarriage and pregnancy disorders. Therefore, a Medline research as well as an analysis of current guidelines on thyroid function and pregnancy was performed.A study focusing on TSH levels in normal and disturbed pregnancies, the risk of miscarriage in association with thyroid autoantibodies, and (subclinical) hypothyroidism in infertile and fertile women were included.Maternal thyroid dysfunction negatively affects pregnancy outcome. Besides a routine iodine supplementation in pregnant women and treatment of hypo as well as hyperthyroidism, TSH levels should routinely be measured in women during childbearing years and adjusted to concentrations < 2.5 mIU/l in order to optimize maternal health and fetal development.