Mehmet ERDOĞAN, Günel BAYRAMOVA, Hatice ÖZIŞIK, Aslı SUNER

Tiroid Disfonksiyonu Olan Gebelerin Demografik Özelliklerinin Araştırılması- Ege Üniversitesi Örneklemi

Amaç: Tiroid hastalıkları maternal ve fetal olumsuzluklara neden olabilir ve gebelikte doğru tanı, takip ve tedavi özel dikkat gerektirir. Gebelikte tiroid fonksiyonlarının değerlendirilmesinde öncelikle Tiroid Stimulan Hormon (TSH), ile birlikte serbest tiroksin (FT4) kullanılır. Çalışmamızda, gebelikte tiroid disfonksiyonunun prevalansını ve etkilerini araştırmayı amaçladık. Gereç ve Yöntemler: Çalışmamız Ege Üniversitesi Endokrinoloji polikliniğinde Kasım 2017-Mayıs 2019 tarihleri arasında 960 gebeyi kapsayan prospektif bir çalışmadır. 960 gebe kadından tiroid disfonksiyonu olan 100 gebe çalışmaya alındı. Anne yaşı, gestasyonel trimester, ailede tiroid hastalığı öyküsü, TSH FT4, serbest triiyodotironin (FT3), anti-tiroid peroksidaz antikoru (Anti-TPO), anti-tiroglobulin antikoru (Anti-TG), TSH reseptör antikoru (TRAb) ile ilgili bilgiler kaydedildi. TSH, FT4 ve FT3 arasındaki korelasyonlar incelendi. Bulgular: Çalışmada gebelerin yaş ortalaması 29.33 ± 5.97 idi. Tüm gebelerin %18’inde anti-TPO antikor pozitifti ve %5’inde Anti-TG antikor pozitifti. 100 hastanın 24’ünde (%24) nodül vardı. Hipertiroidili 1 (%8.3) hasta da TRAb pozitifti. Nodülü olan ve olmayan hastalardaki yaş farklılıkları istatistiksel olarak anlamlı değildi. Hastaların 1’inde (%1) Graves hastalığı, 81’inde (%81) subklinik hipotiroidi, 7’sinde (%7) klinik hipotiroidi, 11’inde (%11) gestasyonel tirotoksikoz vardı. Doğum yapan 45 gebenin verilerine göre 7 hastada (%15.6) prematürite saptandı. Sonuç: Anti-TPO ve anti-TG pozitif olan gebelerde TSH düzeyleri, anti-TPO ve anti-TG negatif olan gebelere göre anlamlı derecede yüksekti. Ayrıca gebelerde tiroid hastalıkları ile nodül sıklığı, otoimmünite, erken doğum arasında ilişki saptanmadı. Daha kapsamlı çalışma serilerine ihtiyaç vardır.

Anahtar Kelimeler:

gebelik, tiroid otoimmunitesi, prematür doğum

Investigation on Demographic Characteristics of Pregnant Patients with Thyroid Dysfunction- Ege University Sample

Aim: Thyroid diseases can cause maternal and fetal adversities, and proper diagnosis, follow-up and treatment during pregnancy requires special attention. In the evaluation of thyroid functions during pregnancy, free thyroxine (FT4) is used primarily with thyroid-stimulating hormone (TSH). Our aim is to investigate the prevalence and the effects of thyroid dysfunction during pregnancy. Material and Methods: Our study is a prospective study including 960 pregnant women and spanning from November 2017 to May 2019 in Ege University Endocrinology outpatient clinic.100 pregnant women with thyroid dysfunction out of 960 pregnant women were included in the study. Maternal age, gestational trimester, family history of the thyroid disorder, TSH, FT4, free triiodothyronine (FT3), anti-thyroid peroxidase antibody (Anti-TPO), anti-thyroglobulin antibody (Anti-TG), thyrotropin (TSH) receptor antibody (TRAb) were collected. The correlations between TSH, FT3 and FT4 were examined. Results: In the study, the mean age of pregnant patients was 29.33 ± 5.97. Anti-TPO was positive %18 and Anti-TG was positive (5%). 24 of 100 (24%) patients had nodules. 1 (8.3%) patient with hyperthyroidism was positive for TRAb. Age differences in patients with or without nodule were not statistically significant. 1 (1%) of the patient had Graves disease, 81 (81%) had subclinical hypothyroidism, 7 (7%) had clinical hypothyroidism, 11 (11%) had gestational thyrotoxicosis. The frequency of prematurity was determined in 7 patients (15.6%) by the data of 45 pregnant women who gave birth. Conclusion: TSH levels in pregnant patients with positivity for anti-TPO and anti-TG were significantly higher than pregnant patients with negativity for anti-TPO and anti-TG. In addition, the relationship between thyroid diseases and nodule frequency, autoimmunity, premature birth in pregnant women were not detected. More comprehensive study series are needed.

Keywords:

pregnancy, thyroid autoimmunity, premature birth,

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