自身免疫性甲状腺疾病对妊娠结局和女性生育功能的影响

The Effect of Autoimmune Thyroid Diseases on Pregnancy Outcomes and Female Fertility

甲状腺自身免疫性疾病是育龄妇女的常见病,包括妊娠期甲状腺功能亢进症、甲状腺功能减退症及产后甲状腺炎。抗甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)及促甲状腺激素受体抗体(TRAb)是机体自身免疫功能紊乱的重要标志。甲状腺功能紊乱对妊娠妇女及胎儿可产生诸多不良影响。甲状腺功能正常但甲状腺自身抗体阳性的妊娠妇女在妊娠期发生甲状腺功能减退、分娩后发生产后甲状腺炎的危险性增高,应注意监测甲状腺功能。甲状腺自身免疫的存在可能与不孕不育以及自然流产等相关。对高危人群进行筛查、早期诊断并及时给予治疗,可有效降低妊娠不良结局的发生。

Thyroid autoimmune diseases are quite prevalent in women of reproductive age, including hyperthy- roidism, hypothyroidism during pregnancy and postpartum thyroiditis. TPOAb, TGAb and TRAb are the important markers of autoimmune thyroid dysfunction. The presence of thyroid dysfunction is associated with some adverse effects on fetal and maternal outcomes. Euthyroid women with positive anti-thyroid antibodies in pregnancy are at increased risks for thyroid insufficiency during pregnancy and postpartum thyroiditis, and should be monitored with TSH and TT4. In addition ,the thyroid autoimmunity may be related with infertility and abortion. Early screening, diagnosis and proper treatment may effectively reduce the occurrence of adverse pregnancy outcomes in high risk individuals.