Finding hypothyroidism during pregnancy, will the baby born be a fool?

Hello everyone, I am a thyroid doctor!

Today I will talk to you about the related issues of hypothyroidism and pregnancy!(There may be a lot of content, please read it patiently …)

Can I get pregnant with hypothyroidism?

First of all, the answer to this question is of course "Yes"!

At present, with the improvement of people’s living standards, people have higher requirements for eugenics. Among pregnancy and pregnant women, the screening of thyroid function has become more and more common.Therefore, many patients with abnormal thyroid function were found.

We know that the lack of iodine or thyroid dysfunction in the mother’s body may cause children to suffer from small symptoms after birth, which is a very serious disease.Therefore, in order to prevent the emergence of small symptoms, it is very important to maintain the normal thyroid function of the mother before and during pregnancy.

Thyroid dysfunction (hypothyroidism) can be divided into clinical hypothyroidism and sub -clinical hypothyroidism according to different degrees of severity and whether clinical manifestations are produced.

The diagnosis of clinical hypothyroidism includes a higher concentration of thyroid hormone (TSH), a decrease in serum thyroid gonadine concentration or only TSH concentration is higher than 10mu/L.The sub -clinical thyroid dysfunction is a biochemical diagnosis based on the increased TSH concentration but normal thyroxine concentration.The treatment of clinical thyroid dysfunction is very clear.

Early pregnancy -based embryo depends on the thyroid hormone of the mother. The thyroid gland of the embryo itself has just begun to have secretion activities at 11 to 13 weeks of pregnancy.Thyroid dysfunction increases the risk of infertility and abortion, and has also affected the development of embryonic nervous system.Therefore, this situation needs to be treated.

The treatment of clinical thyroid dysfunction during pregnancy can bring many benefits to patients, including improving the ending of maternal and newborn.However, the management of women’s sub -clinical thyroid dysfunction and proper treatment targets still lack evidence.

Below, we focus on discussing the treatment of clinical thyroid dysfunction during pregnancy and pregnancy.

I believe that many women encounter such problems during pregnancy. During prenatal examinations and early pregnancy checks, the results of the thyroid function indicate that TSH is higher than 2.5mu/L.Make TSH below 2.5mu/L.

Many women who prepare for pregnancy and pregnancy are very nervous when they see this situation. Will TSH higher than 2.5mu/L cause abortion?Although TSH is 2.5mu/L, why must be thyroxine in the normal range? Will this disease affect the child? Will the children born be a fool?

Generally speaking, the normal range of TSH in different hospitals is almost the same, with 0.3 ~ 4.2mu/L.Considering that thyroid dysfunction is related to infant nerve psychological dysfunction, international guidelines recommendation of pregnancy and pregnancy women TSH should be <2.5mu/L.So far, there are still a lot of centers using this standard. A large number of thyroid hormones are used among women in preparation and early pregnancy to make TSH lower than this value.But this value may be too low and lacks the basis for formulation.Instead, the requirements of this too low TSH value have greatly increased the incidence of clinical hypothyroidism in pregnant women.A clinical study containing more than 17,000 pregnant women in 2007 found that when the pregnancy age was corrected, when TSH exceeded the normal value of 97.5%, 3.4%of the participants were sub -clinical hypothyroidism patients, but the values were 2.5mu 2.5muWhen /L, more than 15%of pregnant women in the United States and New Zealand were ill and Chinese women’s disease ratio was 28%.According to the requirements of the guideline, most pregnant women will start thyroxine supplementary therapy.

The attention of thyroid dysfunction during pregnancy is derived from the correlation between mothers’ thyroid dysfunctional disorder and baby neurological development disorders. This research data comes from clinical hypothyroid people (average TSH is 13.2mu/L), not TSHIt is 2.5mu/L.Many studies have found that the mother TSH is lower than 2.5mu/L, and there is no obvious difference between pregnancy and fetal ending.

Cases from the population of China’s population show whether the mother TSH is lower than specific reference standards (even> 2.5mu/L). There is no significant difference in fetal intelligence and mental movement development.Premature pregnancy, premature birth, premature birth, premature fetal membrane breakdown and other pregnancy complications are more common among sub -clinical thyroid dysfunctional hypothyroidism in TSH value> 4mu/L.Still insufficient.TSH value> 4mu/L sub -clinical thyroid dysfunctional disorder should receive alternative therapy of left thyroid gonadin sodium tablets. The goal of replacement therapy should be controlled below 2.5mu/L.The thyroid antibody (mainly the thyroid peroxidase antibody) is the main cause of the thyroid dysfunction of the sub -clinical thyroid dysfunction and the clinical hypothyroidism.~ 4.0mu/L and anti -thyroid peroxidase -positive women may have better effect on receiving left thyroid gonadine replacement treatment; but without evidence, it can show that thyroid hormone therapy can improveWording or pregnancy ending.

my country has studied more than 8,000 pregnant women’s thyroid dysfunction and children’s intelligent development at 12 to 24 months after the birth of children, and compares the descendants of women with normal thyroid dysfunction and women with normal thyroid function. Clinical thyroid dysfunction has no significant impact on children’s intelligence.

What kind of thyroxine should I choose during pregnancy and during pregnancy?

The answer should be treated with left methylexin (L-T4), which is You Jiale.Tethalithic acid (T4) and tritenueticine (T3) combination, including dried methyl -shaped gland, should not be used in women who are pregnant or are planning to be pregnant.Because there are only a small amount of thyroid hormones that can be passed through the placenta and the secretion of the milk meter is also small, the pregnant women or breasts are taking an appropriate amount of thyroxine on the fetus or baby during the pregnancy.

In short, combined with domestic and foreign guidelines and a large number of studies, the management of thyroid dysfunction in women’s preparation and pregnancy women should follow the following principles:

TPOAB positive: control target: TSH <2.5mu/L.

TPOAB negative: control target TSH <4Mu/L (or normal upper limit of local laboratories), without evidence to prove that TSH supplementation of thyroid hormones between 2.5 and 4mul can improve pregnancy ending; TSH <4Mu/L does not need to supplement thyroxine.

References: Shan Zhongyan, Teng Weiping. "Guidelines for the diagnosis and treatment of thyroid diseases in pregnancy and postpartum" (2nd edition) Point interpretation [J]. Chinese endocrine metabolism magazine, 2019, 35 (8): 632-635. Zhang Qian.The impact of sub -clinical hypothyroidism and TPOAB positive on pregnancy ending [D]. Wenzhou Medical College Wenzhou Medical University, 2013. He Yiping, He Tongqiang, Wang Yanxia, et al. Different standard diagnosis of sub -clinical thyroid dysfunction and thyroid peroxidationThe impact of object enzyme antibodies on pregnancy [J]. Chinese women’s obstetric magazine, 2014, 49 (11): 823-828.chen J, Zhang D. Effect of Euthyroxone Replacement therapy on Maternal and Child Pregnancy out. come inpregnant WOMEN with Hypothyroidism [J]. 2017

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