妊娠期甲状腺功能减退症诊治进展

Update of the diagnosis and treatment of hypothyroidism in pregnancy

研究表明妊娠期临床甲状腺功能减退症（简称甲减）会增加妊娠不良结局的风险，亚临床甲减也可能有类似影响。其诊断应采用TSH和FT4的妊娠三期及方法特异性参考范围进行。最新研究提示评价妊娠4～6周TSH可采用与非妊娠妇女相同参考范围。妊娠期临床甲减必须治疗。妊娠期亚临床甲减伴TPOAb阳性者应接受L—T4治疗，但不必考虑终止妊娠。

It has been found that overt hypothyroidism can increase the risk for adverse outcomes in pregnancy and subclinical hypothyroidism may also have similar effects. The diagnosis of hypothyroidism should be performed based on both trimester- and method-specific reference ranges for serum TSH and FT4. A study has recently reported that the normal reference range of serum TSH in women during 4 -6 weeks of pregnancy should be same as that of non-pregnant females. The pregnant women with overt hypothyroidism must be given with L-thyroxine. Those with both subclinical hypothyroidism and positive TPOAb in the sera should also be treated although termination of pregnancy is not necessary.