İLK TRİMESTER GEBELİKLERİNDE SUBKLİNİK VE AŞİKAR HİPOTİROİDİ İNSİDANSI

Abstract

Amaç Bu çalışma Aksaray ilindeki ilk trimester gebeliklerinde subklinik ve aşikar hipotiroidi sıklığının belirlenmesi amacıyla planlanmıştır. Gereç ve Yöntem Bu bir retrospektif çalışma olup kadın hastalıkları ve doğum polikliniğine gebeliğin 7-12inci haftasında başvuran ve geçmişinde hipotirodi tanısı ve/veya tiroit hormon replasman tedavisi öyküsü bulunmayan tekil 502 gebenin yaş, serum tiroit-stimülan hormon, serbest tri-iyodotronin ve serbest tiroksin düzeyleri hastane kayıt sisteminden elde edildi. Serum TSH için üst sınır 4 mIU/L olarak kabul edildi. Karşılaştırmalarda Mann Whitney U ile ki-kare testleri kullanıldı ve p <0.05 istatistiksel olarak alındı. Bulgular Olguların yaş ortalaması 26.3 ± 5.9 yıl idi. Subklinik ve aşikar hipotiroidi sıklığı sırasıyla %4 ve %0 olarak bulundu. Tiroit fonksiyon test sonuçları normal olan ve subklinik hipotiroidisi olan gebelerin yaşları benzer olarak saptandı (p=0.201). Sonuç Gebelik öncesinde hipotiroidi tanısı olmayan asemptomatik gebelerin ilk trimesterde hipotiroidi açısından taranması, anne yaşından bağımsız olarak aşikar hastalık tanısında kısıtlı role sahip gözükmektedir. Toplum tabanlı trimestere özgül TSH normal referans değerlerinin belirlenmesi, gerçek subklinik hipotiroidi insidansının saptanması bakımından önem taşıyabilir.

Keywords

• Aşikar hipotiroidi
• Gebelik
• Subklinik hipotiroidi
• Tiroit stimülan hormon

THE INCIDENCE OF SUBCLINICAL AND OVERT HYPOTHYROIDISM IN FIRST TRIMESTER PREGNANCIES

Abstract

Objective This study aims to define the first-trimester prevalence of overt and subclinical hypothyroidism in Aksaray province. Material and Methods This is a retrospective study carried out in a single obstetrics and gynecology outpatient unit, including hospital-based data on maternal age, serum thyroidstimulating hormone, thyroxine, and tri-iodothyronine levels from 502 singleton pregnancies at 7-12 weeks of gestational age. Cut-off for serum TSH was considered as 4 mIU/L. Mann-Whitney U and chisquare tests were used for comparisons, with p <0.05 considered statistically significant. Results The mean maternal age was 26.3 ± 5.9 years. Subclinical and overt hypothyroidism was present in 4% and 0% of included women, respectively. Mean maternal age in euthyroid and subclinical hypothyroid pregnancies were similar (p=0.201). Conclusions First trimester screening of asymptomatic women without a prepregnancy diagnosis of hypothyroidism seems to be limited for diagnosing overt hypothyroidism during pregnancy, regardless of maternal age. Definition of population-based trimester specific reference ranges for serum TSH may be important to detect the genuine prevalence of subclinical hypothyroidism

Keywords

• Overt hypothyroidism
• Pregnancy
• Subclinical hypothyroidism
• Thyroid-stimulating hormone

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