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Effects of Levothyroxine Therapy on Pregnancy Outcomes in Women with Subclinical Hypothyroidism

机译：左甲状腺素治疗对亚临床甲状腺功能减退症妇女妊娠结局的影响

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>Background: Subclinical hypothyroidism (SCH) has been associated with increased risk of adverse pregnancy outcomes in some, but not all, studies. Uncertainty remains regarding the impact of levothyroxine (LT4) therapy on improving health outcomes in pregnant women with SCH. The objective of this study was to assess the potential benefits of LT4 therapy in pregnant women with SCH.>Methods: The medical records were reviewed of pregnant women with SCH, defined as an elevated serum thyrotropin (TSH) of >2.5 mIU/L for the 1st trimester or >3 mIU/L for the 2nd and 3rd trimesters, but ≤10 mIU/L. Pregnant women were divided into two groups depending on whether they received LT4 (group A) or not (group B). Pregnancy loss and other pre-specified adverse outcomes were evaluated during follow-up.>Results: There were 82 women in group A and 284 in group B. Group A had a higher body mass index (p = 0.04) and a higher serum TSH level (p < 0.0001) compared with group B. Group A had fewer pregnancies lost (n = 5 [6.1%] vs. n = 25 [8.8%]; p = 0.12), low birth weight (LBW) offspring (1.3% vs. 10%; p < 0.001), and no neonates with a five-minute Apgar score ≤7 (0% vs. 7%; p < 0.001) compared with group B. Other pregnancy-related adverse outcomes were similar between the two groups. Inferences remained unchanged after considering different models to adjust for potential predictors of outcome.>Conclusions: LT4 therapy is associated with a decreased risk of LBW and a low Apgar score among women with SCH. This association awaits confirmation in randomized trials before the widespread use of LT4 therapy in pregnant women with SCH.
机译：>背景：在一些（但不是全部）研究中，亚临床甲状腺功能减退症（SCH）与不良妊娠结局的风险增加相关。关于左甲状腺素（LT4）治疗对SCH孕妇改善健康结局的影响尚不确定。这项研究的目的是评估LT4疗法对SCH孕妇的潜在益处。>方法：回顾了SCH孕妇的病历，其定义为SCH的血清促甲状腺激素（TSH）升高。妊娠前三个月> 2.5µmIU / L，妊娠中期和第二三个月> 3µmIU / L，但≤10µmIU / L。孕妇根据是否接受LT4（A组）分为两组（B组）。 >结果： A组中有82名妇女，B组中有284名妇女。A组的体重指数较高（p = 0.04） ），血清TSH水平高于B组（p <0.0001）。A组的妊娠流产较少（n = 5 [6.1％] vs. n = 25 [8.8％]； p = 0.12），出生体重低（ LBW）的后代（1.3％比10％； p <0.001），且五分钟Apgar得分不超过7分的新生儿（0％比7％; p <0.001）。两组之间的结果相似。在考虑使用不同模型来调整可能的结局预测因素后，推论保持不变。>结论： LT4治疗与SCH患者的LBW风险降低和Apgar评分低有关。该协会在接受SCH4孕妇广泛使用LT4治疗之前，等待随机试验的证实。

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