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JCEM:孕妇甲状腺功能和孕早期使用抗甲状腺药物与出生缺陷的关系

2019-08-14 xing.T MedSci原创

由此可见,该研究的结果证实妊娠早期使用ATD导致出生缺陷的风险增加,并表明孕妇甲状腺功能异常不是出生缺陷的主要危险因素。

妊娠早期的抗甲状腺药物(ATD)治疗与出生缺陷有关,但需要更多的数据来证实与不同类型ATD相关的风险。此外,孕妇甲状腺功能异常的作用仍未明确。近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,该研究通过全国范围扩大队列旨在评估使用ATD相关的出生缺陷风险以及孕妇甲状腺功能异常的作用。

该研究的参与者为丹麦孕妇及其活产儿童,纳入了1997-2016年期间全国登记册(NRBC)的1242353名儿童;1997-2003年期间丹麦国家出生队列(DNBC)的8803名儿童;以及2011-2015年期间来自北丹麦地区妊娠队列(NDRPC)的14483名儿童。该研究的主要观察指标为在两岁前确诊的出生缺陷。

在NRBC,共有2718名(0.2%)儿童的母亲在妊娠早期接触过ATD。出生缺陷的总体频率在未暴露儿童中为6.7%(95%置信区间(CI):6.7-6.8%),在接触甲巯咪唑/卡比马唑(9.6%(95%CI:8.2-11.2%) )和丙硫氧嘧啶(8.3%(6.7-10.3%))后更高。另一方面,随机队列和DNBC(12.4% vs. 12.6%,p=0.8)和NDRPC(15.1 vs. 15.4%,p=0.8)出生缺陷病例中妊娠早期母体甲状腺功能异常的发生率相似。

由此可见,该研究的结果证实妊娠早期使用ATD导致出生缺陷的风险增加,并表明孕妇甲状腺功能异常不是出生缺陷的主要危险因素。 

原始出处:

Stine Linding Andersen,et al.Maternal thyroid function, use of antithyroid drugs in early pregnancy and birth defects.J Clin Endocrinol Metab. 2019.https://doi.org/10.1210/jc.2019-01343

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    2020-07-02 achengzhao
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    2019-12-13 smallant2015
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