DOI: https://doi.org/10.18370/2309-4117.2012.5.10-12

Субклінічна гіпофункція щитоподібної залози у вагітних з аутоімунологічним захворюванням залози

Юзеф Кшисєк, Томаш Мілєвіч, Сандра Мрозінська, Марта Кялка, Агнєшка Оцєпка, Магдалена Пулька, Єва Стохмаль, Магдалена Кшичковська-Сендраковська, Злата Чайківська, Еліна Чайківська

Abstract


Захворювання щитоподібної залози (ЩЗ) у вагітних зумовлюють розвиток порушень функцій ЩЗ у плода, а також ускладнюють перебіг гестаційного процесу. Тому серед ендокринологів та гінекологів актуальною є проблема тиреологічного нагляду за вагітною. Важливим аспектом правильного контролю функцій ЩЗ є оцінка концентрації тиреотропного гормона (ТТГ), вільного трийодтироніну (fТ3) та вільного тироксину (fТ4). При цьому найбільше сумнівів пов’язано з референційними показниками концентрації ТТГ, fT3 і fT4 в окремих триместрах вагітності [12, 25].

References


Abalovich M., Amino N., Barbour L.A. et al.Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 2007; 92 (8 Suppl.): S1-S47.

Banhadi N., Wiersinga W.M., Reitsma J.B., Vrijkotte T.G.M., Bonsel G.J. Higher maternal TSH levels in pregnancy are associated with increased risk of miscarriage, fetal or neonatal death. Eur. J. Endocrinol. 2009; 160: 985-991.

Banhadi N., Wiersinga W.M., Reitsma J.B., Vrijkotte T.G.M., van der Wal M.F., Bonsel G.J.Ethnic differences in TSH but not in free T4 concentrations or TPO antibodies during pregnancy. Clin. Endocrinol. 2007; 66: 765-770.

Cotzias C., Wong S.J., Taylor E., Seed P., Girling J. A study to establish gestation-specific reference intervals for thyroid function tests in normal singleton pregnancy. Eur. J. Obstet. Gynecol. Reprod. Biol. 2008; 137: 61-66.

De Vivi A., Mancuso A., Giaccobbe A. et al. Thyroid function in women found to have early pregnancy loss. Thyroid 2010; 20: 633-637.

Hamm M.P., Cherry N.M., Martin J.W., Bamforth F., Edmonton A.B. The impact of isolated maternal hypothyroxinemia on perinatal morbidity. J. Obstet. Gynaecol. Can. 2009; 31: 1015-1021.

Henrichs J., Bongers-Schokking J.J., Schenk J.J. et al. Maternal thyroid function during early pregnancy and cognitive functioning in early childhood: the generation R study. J. Clin. Endocrinol. Metab. 2010; 95: 4227-4234.

Iravatani A.T., Saeedi M.M., Pakravesh J., Hamidi S., Abbasi M. Thyroid autoimmunity and recurrent spontaneous abortion in Iran: a case-control study. Endocr. Pract. 2008; 14: 458-464.

Karbownik-Lewińska M. Thyroid dysfunction during pregnancy. Invited Lecture. 11th European Congress of Endocrinology 25-29.04.2009 r., Istanbul, Turcja, Endocr. Abstr. 2009; 20, S26.2.

Karbownik-Lewińska M., Zygmunt A. Choroby endokrynologiczne u kobiet w ciąży i w okresie fizjologicznej laktacji. In: Lewiński A, Zygmunt A (eds). Diagnostyka czynnościowa zaburzeń hormonalnych z elementami diagnostyki rożnicowej. Czelej, Lublin 2011: 241-250.

Koutras D.A. Thyroidopaties. Ann. N.Y. Acad. Sci., 2000, 900, 77-88.

Krysiak R., Okopień B., Herman Z.S. Nadczynność tarczycy w ciąży. Pol. Merk. Lek., 2006, XXI, 126, 579.

Lambert-Messarlian G., Mcclain M., Haddow J.E. et al. and the FaSTER Consortium. First and second trimester thyroid hormone reference data in pregnant women: a FaSTER (First and Second Trimester Evaluation of Risk for aneuploidy) Research Consortium study. Am. J. Obstet. Gynecol. 2008; 1999: 62e.1-62e6.

La’Ulu S.L., Roberts W.L. Second-trimester reference intervals for thyroid tests: the role of ethnicity. Clinical Chemistry 2007; 53: 1658-1664.

Li Y., Shan Z., Teng W. et al.Abnormalities of maternal thyroid function during pregnancy affect neuropsychological development of their children at 25-30 months. Clin. Endocrinol. 2010; 72: 825-829.

Malkawi O.M. Thyroid disease and pregnancy. Saudi Med. J. 2002, 23, 633-639.

Mannisto T., Vaarasmaki M., Pouta A. et al. Perinatal outcome of children born to mothers with thyroid dysfunction or antibodies: a prospective population-based cohort study. J. Clin. Endocrinol. Metab. 2009; 94: 772-779.

Nunez J. Effects of thyroid hormones during brain differentiation. Mol. Cell. Endocrinol. 1984. 37: 125-132.

Oken E., Braverman L.E., Platek D., Mitchell M.L., Lee S.L., Pearce E.N. Neonatal thyroxine, maternal function and child cognition. J. Clin. Endocrinol. Metab. 2009; 94: 497-503.

Sahu M.T., Das V., Mittal S., Agarwal A., Sahu M. Overt and subclinical thyroid dysfunction among Indian pregnant women and its effect on maternal and fetal outcome. Arch Gynecol. Obstet. 2010; 81: 215-220.

Patel J., Landers K., Li H., Mortimer R.H., Richard K. J. Endocrinol. Thyroid hormones and fetal neurological development. 2011 Apr; 209 (1): 1-8. Epub. 2011, Jan 6.

Patel J., Landers K., Li H., Mortimer R.H., Richard K. Delivery of maternal thyroid hormones to the fetus. Trends Endocrinol. Metab. 2011, Mar 15.

Porterfield S.P., Hendrich, C.E. The role of thyroid hormones in prenatal and neonatal neurological development - current perspectives. Endocr. Rev. 1993. 14: 94-106.

Schwartz H.L. Effect of thyroid hormone on growth and development. In: Molecular basis of thyroid hormone action (Oppenheimer, JH, Samuels, HH), New York: Academic Press. 1983, pp. 413-444.

Springer D., Zima T., Limanova Z. Reference intervals in evaluation of maternal thyroid function during the first trimester of pregnancy. Eur. J. Endocrinol. 2009; 160: 791-797.

Stricker R., Echenard M., Eberhard R. et al. Evaluation of maternal thyroid function during pregnancy: the importance of using gestational age-specific reference intervals. Eur. J. Endocrinol. 2007; 157: 509-514.

Wasserman E.E., Nelson K., Rose N.R. et al. Maternal thyroid autoantibodies during the third trimester and hearing deficits in children: an epidemiologic assessment. Am. J. Epidemiol. 2008; 167: 701-710.

Hubalewska-Dydejczyk A. і wsp. Postępowanie w chorobach tarczycye u kobiet w ciąży. Endokrynologia Polska, Tom 63, Nr 4. 2011, str. 362-380.

Tomasz Milewicz, Małgorzata Żuk, Ewa Stochmal i wsp. Wiek, miejsce zamieszkania i wykształcenie wpływają na zgłaszalność ciężarnych do badań przesiewowych funkcji tarczycy – badanie ankietowe. Endokrynol. Pol. 2011; 62 (5): 416-420.


GOST Style Citations


Abalovich M., Amino N., Barbour L.A. et al.Management of thyroid dysfunction during pregnancy and postpartum: an Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab. 2007; 92 (8 Suppl.): S1-S47.

Banhadi N., Wiersinga W.M., Reitsma J.B., Vrijkotte T.G.M., Bonsel G.J. Higher maternal TSH levels in pregnancy are associated with increased risk of miscarriage, fetal or neonatal death. Eur. J. Endocrinol. 2009; 160: 985-991.

Banhadi N., Wiersinga W.M., Reitsma J.B., Vrijkotte T.G.M., van der Wal M.F., Bonsel G.J.Ethnic differences in TSH but not in free T4 concentrations or TPO antibodies during pregnancy. Clin. Endocrinol. 2007; 66: 765-770.

Cotzias C., Wong S.J., Taylor E., Seed P., Girling J. A study to establish gestation-specific reference intervals for thyroid function tests in normal singleton pregnancy. Eur. J. Obstet. Gynecol. Reprod. Biol. 2008; 137: 61-66.

De Vivi A., Mancuso A., Giaccobbe A. et al. Thyroid function in women found to have early pregnancy loss. Thyroid 2010; 20: 633-637.

Hamm M.P., Cherry N.M., Martin J.W., Bamforth F., Edmonton A.B. The impact of isolated maternal hypothyroxinemia on perinatal morbidity. J. Obstet. Gynaecol. Can. 2009; 31: 1015-1021.

Henrichs J., Bongers-Schokking J.J., Schenk J.J. et al. Maternal thyroid function during early pregnancy and cognitive functioning in early childhood: the generation R study. J. Clin. Endocrinol. Metab. 2010; 95: 4227-4234.

Iravatani A.T., Saeedi M.M., Pakravesh J., Hamidi S., Abbasi M. Thyroid autoimmunity and recurrent spontaneous abortion in Iran: a case-control study. Endocr. Pract. 2008; 14: 458-464.

Karbownik-Lewińska M. Thyroid dysfunction during pregnancy. Invited Lecture. 11th European Congress of Endocrinology 25-29.04.2009 r., Istanbul, Turcja, Endocr. Abstr. 2009; 20, S26.2.

Karbownik-Lewińska M., Zygmunt A. Choroby endokrynologiczne u kobiet w ciąży i w okresie fizjologicznej laktacji. In: Lewiński A, Zygmunt A (eds). Diagnostyka czynnościowa zaburzeń hormonalnych z elementami diagnostyki rożnicowej. Czelej, Lublin 2011: 241-250.

Koutras D.A. Thyroidopaties. Ann. N.Y. Acad. Sci., 2000, 900, 77-88.

Krysiak R., Okopień B., Herman Z.S. Nadczynność tarczycy w ciąży. Pol. Merk. Lek., 2006, XXI, 126, 579.

Lambert-Messarlian G., Mcclain M., Haddow J.E. et al. and the FaSTER Consortium. First and second trimester thyroid hormone reference data in pregnant women: a FaSTER (First and Second Trimester Evaluation of Risk for aneuploidy) Research Consortium study. Am. J. Obstet. Gynecol. 2008; 1999: 62e.1-62e6.

La’Ulu S.L., Roberts W.L. Second-trimester reference intervals for thyroid tests: the role of ethnicity. Clinical Chemistry 2007; 53: 1658-1664.

Li Y., Shan Z., Teng W. et al.Abnormalities of maternal thyroid function during pregnancy affect neuropsychological development of their children at 25-30 months. Clin. Endocrinol. 2010; 72: 825-829.

Malkawi O.M. Thyroid disease and pregnancy. Saudi Med. J. 2002, 23, 633-639.

Mannisto T., Vaarasmaki M., Pouta A. et al. Perinatal outcome of children born to mothers with thyroid dysfunction or antibodies: a prospective population-based cohort study. J. Clin. Endocrinol. Metab. 2009; 94: 772-779.

Nunez J. Effects of thyroid hormones during brain differentiation. Mol. Cell. Endocrinol. 1984. 37: 125-132.

Oken E., Braverman L.E., Platek D., Mitchell M.L., Lee S.L., Pearce E.N. Neonatal thyroxine, maternal function and child cognition. J. Clin. Endocrinol. Metab. 2009; 94: 497-503.

Sahu M.T., Das V., Mittal S., Agarwal A., Sahu M. Overt and subclinical thyroid dysfunction among Indian pregnant women and its effect on maternal and fetal outcome. Arch Gynecol. Obstet. 2010; 81: 215-220.

Patel J., Landers K., Li H., Mortimer R.H., Richard K. J. Endocrinol. Thyroid hormones and fetal neurological development. 2011 Apr; 209 (1): 1-8. Epub. 2011, Jan 6.

Patel J., Landers K., Li H., Mortimer R.H., Richard K. Delivery of maternal thyroid hormones to the fetus. Trends Endocrinol. Metab. 2011, Mar 15.

Porterfield S.P., Hendrich, C.E. The role of thyroid hormones in prenatal and neonatal neurological development - current perspectives. Endocr. Rev. 1993. 14: 94-106.

Schwartz H.L. Effect of thyroid hormone on growth and development. In: Molecular basis of thyroid hormone action (Oppenheimer, JH, Samuels, HH), New York: Academic Press. 1983, pp. 413-444.

Springer D., Zima T., Limanova Z. Reference intervals in evaluation of maternal thyroid function during the first trimester of pregnancy. Eur. J. Endocrinol. 2009; 160: 791-797.

Stricker R., Echenard M., Eberhard R. et al. Evaluation of maternal thyroid function during pregnancy: the importance of using gestational age-specific reference intervals. Eur. J. Endocrinol. 2007; 157: 509-514.

Wasserman E.E., Nelson K., Rose N.R. et al. Maternal thyroid autoantibodies during the third trimester and hearing deficits in children: an epidemiologic assessment. Am. J. Epidemiol. 2008; 167: 701-710.

Hubalewska-Dydejczyk A. і wsp. Postępowanie w chorobach tarczycye u kobiet w ciąży. Endokrynologia Polska, Tom 63, Nr 4. 2011, str. 362-380.

Tomasz Milewicz, Małgorzata Żuk, Ewa Stochmal i wsp. Wiek, miejsce zamieszkania i wykształcenie wpływają na zgłaszalność ciężarnych do badań przesiewowych funkcji tarczycy – badanie ankietowe. Endokrynol. Pol. 2011; 62 (5): 416-420.





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