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中华产科急救电子杂志 ›› 2023, Vol. 12 ›› Issue (04) : 202 -205. doi: 10.3877/cma.j.issn.2095-3259.2023.04.003

妊娠合并内分泌疾病

妊娠合并甲状腺功能减退的管理
朱晔, 张晓红()   
  1. 100044 北京大学人民医院妇产科
  • 收稿日期:2023-07-23 出版日期:2023-11-18
  • 通信作者: 张晓红

Pregnancy management of the patients complicated with hypothyroidism

Ye Zhu, Xiaohong Zhang()   

  • Received:2023-07-23 Published:2023-11-18
  • Corresponding author: Xiaohong Zhang
引用本文:

朱晔, 张晓红. 妊娠合并甲状腺功能减退的管理[J]. 中华产科急救电子杂志, 2023, 12(04): 202-205.

Ye Zhu, Xiaohong Zhang. Pregnancy management of the patients complicated with hypothyroidism[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2023, 12(04): 202-205.

甲状腺在妊娠期对于母体和胎儿的健康发挥着至关重要的作用。妊娠早期缺乏甲状腺激素会导致胎儿智力发育低下、胎儿神经系统发育异常、影响胎儿的体重和身长等。本文将对妊娠合并甲状腺功能减退疾病的孕前咨询、孕期及产后管理进行讨论。

The thyroid gland playes a vital role in the health of the maternal and the fetus during pregnancy. Lack of thyroid hormone in early pregnancy leds to low fetal intellectual development, abnormal fetal nervous system development, and affects fetal weight and length. The article will discuss the pre-pregnancy consultation and pregnancy management of the patients complicated with hypothyroidism, as well as postpartum treatment.

[1]
Smetnik AA, Sencha AN, Pavlovich SV. Thyroid disorders and female reproductive system diseases: the thyroid gland and pregnancy[J]. Thyroid Ultrasound2019:203-213.
[2]
ACOG committee. Thyroid disease in pregnancy: ACOG practice bulletin, number 223[J]. Obstet Gynecol2020135(6):e261-274.
[3]
《孕产期甲状腺疾病防治管理指南》编撰委员会,中华医学会内分泌学分会中华预防医学会妇女保健分会. 孕产期甲状腺疾病防治管理指南[J]. 中华内分泌代谢杂志202238(7):539-551
[4]
Alexander EK, Pearce EN, Brent GA, et al. 2017 guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and the postpartum[J]. Thyroid201727(3):315-389.
[5]
Dong AC, Stagnaro-Green A. Differences in diagnostic criteria mask the true prevalence of thyroid disease in pregnancy: a systematic review and meta-analysis[J]. Thyroid201929(2):278-289.
[6]
Korevaar TI, de Rijke YB, Chaker L, et al. Stimulation of thyroid function by human chorionic gonadotropin during pregnancy: a risk factor for thyroid disease and a mechanism for known risk factors[J]. Thyroid201727(3):440-450.
[7]
Ollero MD, Toni M, Pineda JJ, et al. Thyroid function reference values in healthy iodine-sufficient pregnant women and influence of thyroid nodules on thyrotropin and free thyroxine values[J]. Thyroid201929(3):421-429.
[8]
Cai L, Wang P, Xue C, et al. Clinical characteristics and risk factors associated with adverse pregnancy outcomes in patients with gestational hypothyroidism: a case control study[J]. Endocr Pract2023:1-4.
[9]
高劲松,边旭明. 妊娠合并甲状腺功能减退症的研究进展[J]. 中华妇产科杂志201247(9):697-700
[10]
Gottwald-Hostalek U, Kahaly GJ. Optimising levothyroxine treatment for subclinical hypothyroidism during pregnancy[J]. Curr Med Res Opin202328:1-12.
[11]
Pande A, Anjankar A. A narrative review on the effect of maternal hypothyroidism on fetal development[J]. Cureus202315(2):1-8.
[12]
Toloza FJK, Derakhshan A, Männistö T, et al. Association between maternal thyroid function and risk of gestational hypertension and pre-eclampsia: a systematic review and individual-participant data meta-analysis[J]. Lancet Diabetes Endocrinol202210(4):243-252.
[13]
Lee SY, Cabral HJ, Aschengrau A, et al. Associations between maternal thyroid function in pregnancy and obstetric and perinatal outcomes[J]. J Clin Endocrinol Metab2020105(5):e2015-2023.
[14]
Korevaar TIM, Derakhshan A, Taylor PN. Association of thyroid function test abnormalities and thyroid autoimmunity with preterm birth: a systematic review and meta-analysis[J]. JAMA2019322:632-641.
[15]
Lee SY, Pearce EN. Assessment and treatment of thyroid disorders in pregnancy and the postpartum period[J]. Nat Rev Endocrinol202218(3):158-171.
[16]
Thompson W, Russell G, Baragwanath G, et al. Maternal thyroid hormone insufficiency during pregnancy and risk of neurodevelopmental disorders in offspring: a systematic review and meta-analysis[J]. Clin Endocrinol (Oxf)201888(4):575-584.
[17]
Velasco I, Vila L, Goya M, et al. Executive summary of the SEEN (Sociedad Española de Endocrinología y Nutrición[Spanish Society of Endocrinology and Nutrition])-SEGO (Sociedad Española deGinecología y Obstetricia [Spanish Society of Gynaecology and Obstetrics]) consensusdocument on the management of thyroid dysfunction during pregnancy[J]. Endocrinol Diabetes Nutr (Engl Ed)202370 Suppl 1:38-50.
[18]
《妊娠和产后甲状腺疾病诊治指南》(第2版)编撰委员会,中华医学会内分泌学分会,中华医学会围产医学分会. 妊娠和产后甲状腺疾病诊治指南(第2版)[J].中华内分泌代谢杂志201935(8):636-665.
[19]
Springer D, Jiskra J, Limanova Z, et al. Thyroid in pregnancy: from physiology to screening[J]. Crit Rev Clin Lab Sci201754(2):102-116.
[20]
Yamamoto JM, Benham JL, Nerenberg KA, et al. Impact of levothyroxine therapy on obstetric, neonatal and childhood outcomes in women with subclinical hypothyroidism diagnosed in pregnancy: a systematic review and meta-analysis of randomised controlled trials[J]. BMJ Open20188(9):1-10.
[21]
Hardley MT, Chon AH, Mestman J, et al. Iodine-induced fetal hypothyroidism: diagnosis and treatment with intra-amniotic levothyroxine[J]. Horm Res Paediatr201890(6):419-423.
[22]
LaFranchi SH. Thyroid function in preterm/low birth weight infants: impact on diagnosis and management of thyroid dysfunction[J]. Front Endocrinol (Lausanne)202112:1-9.
[23]
Kobayashi M, Yagasaki H, Saito T, et al. Fetal goitrous hypothyroidism treated by intra-amniotic levothyroxine administration: case report and review of the literature[J]. J Pediatr Endocrinol Metab201730(9):1001-1005.
[24]
Mégier C, Dumery G, Luton D. Iodine and thyroid maternal and fetal metabolism during pregnancy[J]. Metabolites202313(5):1-22.
[25]
Iijima S. Current knowledge about the in utero and peripartum management of fetal goiter associated with maternal Graves′ disease[J]. Eur J Obstet Gynecol Reprod Biol X20193:1-7.
[26]
Nemescu D, Tanasa IA, Stoian DL, et al. Conservative in utero treatment of fetal dyshormonogenetic goiter with levothyroxine, a systematic literature review[J]. Exp Ther Med202020(3):2434-2438.
[27]
Blumenfeld YJ, Davis A, Milan K, et al. Conservatively managed fetal goiter: an alternative to in utero therapy[J]. Fetal Diagn Ther201334(3):184-187.
[28]
Mastrolia SA, Mandola A, Mazor M, et al. Antenatal diagnosis and treatment of hypothyroid fetal goiter in an euthyroid mother: a case report and review of literature. [J] J Matern Fetal Neonatal Med201528(18):2214-2220.
[29]
Baumann NA, Gronowski AM. Establishment of reference intervals for thyroid-stimulating hormone and free thyroxine in amniotic fluid using the Bayer ADVIA Centaur[J]. Am J Clin Pathol2007128(1):158-163.
[30]
Hidaka N, Soejima C, Sato M, et al. Successful intra-amniotic levothyroxine treatment for fetal goitrous hypothyroidism in a triplet pregnancy[J]. J Obstet Gynaecol Res202248(12):3319-3324.
[31]
Nǎstase L, Cristea O, Diaconu A, et al. Two cases of congenital hypothyroidism revealing thyroid agenesis[J]. Medicina (Kaunas)202359(10):1-12.
[32]
Cohen O, Pinhas-Hamiel O, Sivan E, et al. Serial in utero ultrasonographic measurements of the fetal thyroid: a new complementary tool in the management of maternal hyperthyroidism in pregnancy[J]. Prenat Diagn200323(9):740-742.
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