背景:妊娠期甲状腺功能障碍会影响母胎健康,并可能影响儿童的神经认知发育。怀孕期间甲状腺生理变化,需要建立每个三个月以及每个人群和方法的特定参考水平。我们研究的目的是分析整个妊娠期间的甲状腺功能,并为我们的人群和方法建立每个妊娠中期的TSH和T4L参考水平。
方法:2018年3月至2020年10月对598名孕妇进行前瞻性分析研究。TSH,T4L,T3L,ATPO和ATG均被测定。共有151名孕妇因甲状腺免疫阳性而被排除在外,以前用左甲状腺素治疗的甲状腺疾病,双胎妊娠,诊断甲状腺功能减退和甲状腺功能亢进的要求或缺乏的一些参数研究,参考人口为447名孕妇。
结果:第一次TSH的参考水平为0.07-3.14mIU/L,第2个月为0.66-3.21mIU/L,第3个月为0.52-2.97mIU/L。第一次T4L的参考水平为0.81-1.19ng/dL,第2个月为0.71-1.07ng/dL,第3个月为0.69-1.06ng/dL。
结论:本研究中获得的TSH和T4L参考水平与普通人群不同,这可能导致错误分类错误和孕妇不必要的治疗。
BACKGROUND: Thyroid dysfunction during gestation impacts on maternal-fetal health and may influence the neurocognitive development of the child. Thyroid physiology changes during pregnancy and requires the establishment of specific reference levels per trimester and for each population and method. The objectives of our study were to analyse thyroid function throughout pregnancy and to establish reference levels for TSH and T4L in each trimester for our population and methodology.
METHODS: Prospective analytical study of 598 pregnant women from March 2018 to October 2020. TSH, T4L, T3L, ATPO and ATG were determined in all of them. A total of 151 pregnant women were excluded due to positive thyroid immunity, previous thyroid disease in treatment with levothyroxine, twin pregnancy, diagnosis of hypothyroidism and hyperthyroidism in the request or absence of some of the parameters studied, with a reference population of 447 pregnant women.
RESULTS: The reference levels for TSH were 0.07-3.14mIU/L for the first, 0.66-3.21mIU/L for the second and 0.52-2.97mIU/L for the third trimester. Reference levels for T4L were 0.81-1.19ng/dL for the first, 0.71-1.07ng/dL for the second and 0.69-1.06ng/dL for the third trimester.
CONCLUSIONS: The reference levels for TSH and T4L obtained in this study differ from those used for the general population, which may have led to misclassification errors and unnecessary treatment in pregnant women.