单胎妊娠合并妊娠期甲状腺功能减退对妊娠 结局影响的研究进展
Research Progress on the Effect of Singleton Pregnancy Combined with Gestational Hypothyroidism on Pregnancy Outcomes
DOI: 10.12677/acm.2026.163906, PDF,   
作者: 朱隆基：西安医学院研究生工作部，陕西 西安；董 晋*：西北妇女儿童医院产科，陕西 西安
关键词: 单胎妊娠；甲状腺功能减退；妊娠结局；亚临床甲减；左甲状腺素；Singleton Pregnancy； Hypothyroidism； Pregnancy Outcomes； Subclinical Hypothyroidism； Levothyroxine
摘要: 妊娠期甲状腺功能减退是育龄期女性常见的内分泌异常，在妊娠人群中具有一定发生基础。甲状腺激素在妊娠过程中参与母体代谢调节、胎盘形成以及胎儿生长和神经系统发育等多个生理环节。既往研究提示，单胎妊娠合并甲状腺功能减退与多种不良妊娠结局存在相关性，包括流产、早产、妊娠期高血压疾病、胎儿生长受限及新生儿不良结局等。然而，不同研究在研究对象构成、诊断标准及干预措施等方面存在差异，相关结论尚不完全一致，尤其是亚临床甲状腺功能减退对妊娠结局的影响及其管理策略仍缺乏统一认识。本文围绕单胎妊娠合并甲状腺功能减退，从疾病定义与分类、流行病学特征、母体及胎儿妊娠结局、治疗干预证据以及相关指南与共识等方面进行综述，以期为妊娠期甲状腺功能减退的临床管理及后续研究提供参考。
Abstract: Hypothyroidism during pregnancy is a common endocrine abnormality in women of childbearing age, which has a certain basis for occurrence in pregnant people. Thyroid hormones are involved in multiple physiological links during pregnancy, such as maternal metabolic regulation, placental formation, fetal growth and nervous system development. Previous studies suggest that singleton pregnancy combined with hypothyroidism is associated with a variety of adverse pregnancy outcomes, including miscarriage, preterm birth, gestational hypertension, fetal growth restriction, and adverse neonatal outcomes. However, there are differences in the composition, diagnostic criteria and interventions of different studies, and the relevant conclusions are not completely consistent, especially the impact of subclinical hypothyroidism on pregnancy outcomes and its management strategies are still lacking unified understanding. This article reviews singleton pregnancies with hypothyroidism, from the aspects of disease definition and classification, epidemiological characteristics, maternal and fetal pregnancy outcomes, evidence for therapeutic intervention, and relevant guidelines and consensus, in order to provide reference for the clinical management and follow-up research of hypothyroidism in pregnancy.
文章引用：朱隆基, 董晋. 单胎妊娠合并妊娠期甲状腺功能减退对妊娠 结局影响的研究进展[J]. 临床医学进展, 2026, 16(3): 1287-1297. https://doi.org/10.12677/acm.2026.163906

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