亚临床甲状腺功能减退症与妊娠

Subclinical hypothyroidism and pregnancy

妊娠期亚临床甲状腺功能减退症（甲减）的患病率较高，美国流行病调查显示约占妊娠妇女的2％．5％。多项研究证实妊娠妇女患亚临床甲减可影响其后代的智力发育，并可能产生各种产科并发症。妊娠期亚临床甲减影响后代智力发育的确切机制尚不清楚。专家多主张对血清促甲状腺激素升高的孕妇或计划怀孕的妇女，应及时给予左旋甲状腺素治疗。但是对于妊娠期妇女是否应常规进行亚临床甲减的筛查仍存在争议，另外左旋甲状腺素替代治疗的效果还需大量循证医学资料来证实。

Subclinical hypothyroidism has a prevalence of 2% to 5 % in pregnant women. Several studies show subclinical maternal hypothyroidism might be harmful to embryofetal brain development, and associate with poor pregnancy complications. It is not clear how subclinical hypothyroidism, where there is normal thyroxine, impairs fetal brain development. Specialists recommend that pregnant women whose thyroid-stimulating hormone elevated should be given thyroxine supplementation in time. But there is not enough evidence to determine whether screening for subclinical hypothyroidism before or during pregnancy in the asymptomatic woman is warranted or necessary. It should conduct a randomized controlled trial in women with subclinical hypothyroidism because the outcomes and benefits of supplemental treatment are uncertain.