UNASSIGNED: To determine the prevalence and possible clinical and biological risk factors of biochemical progression (rise in serum thyroid-stimulating hormone (TSH) > 2.5 mU/L) at second blood sampling during pregnancy, in euthyroid women (TSH ≤ 2.5 mU/L) according to their TPOAb status.
UNASSIGNED: This study included demographic and biological data from two previously published cohorts (n = 274 women from August 1996 to May 1997 Copenhagen cohort, and n = 66 women from January 2013 to December 2014 Brussels cohort) having at least two measurements of TSH and free thyroxine (FT4) and at least one of TPOAb during spontaneously achieved singleton pregnancies.
UNASSIGNED: The majority of women studied did not show biochemical progression. Only 4.2% progressed, significantly more frequently among TPOAb+ women, as compared to TPOAb- group (9.4 vs 2.7%, P = 0.015). No rise in serum TSH > 4 mU/L at 2nd sampling was observed. Higher baseline TSH levels were associated with biochemical progression in both TPOAb+ (P = 0.05) and TPOAb- women (P < 0.001), whereas maternal age, BMI, multiparity, smoking, FT4, and TPOAb concentrations were not significantly different between women with and without progression.
UNASSIGNED: Only a minority of euthyroid women with thyroid autoimmunity presented biochemical progression and none with a TSH > 4 mU/L. Larger studies are needed to better target the subset of women who would benefit most from repeated thyroid function monitoring during pregnancy.
目的:确定妊娠期第二次采血时生化进展(血清TSH升高>2.5mU/L)的患病率和可能的临床和生物学危险因素,根据TPOAb状态,甲状腺功能正常的女性(TSH≤2.5mU/L)。
方法:本研究包括两个先前发表的队列的人口统计学和生物学数据(n=274名妇女,1996年8月至1997年5月哥本哈根队列,2013年1月至2014年12月的66名女性,布鲁塞尔队列)在自发性单胎妊娠期间进行了至少两次TSH和游离甲状腺素(FT4)以及至少一次TPOAb的测量。
结果:研究的大多数女性没有出现生化进展。只有4.2%的进步,在TPOAb+女性中更频繁,与TPOAb组相比(9.4%vs2.7%,p=0.015)。在第二次采样时没有观察到血清TSH>4mU/L的升高。较高的基线TSH水平与TPOAb+(p=0.05)和TPOAb-女性(p<0.001)的生化进展有关,而母亲的年龄,BMI,多重奇偶校验,吸烟,FT4和TPOAb浓度在有和没有进展的女性之间没有显着差异。
结论:只有少数甲状腺自身免疫正常的妇女出现生化进展,没有TSH>4mU/L。需要进行更大规模的研究,以更好地针对怀孕期间从重复甲状腺功能监测中受益最大的女性子集。