دوره 13، شماره 7 - ( 6-1394 )                   جلد 13 شماره 7 صفحات 396-387 | برگشت به فهرست نسخه ها

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Nazarpour S, Ramezani Tehrani F, Simbar M, Azizi F. Thyroid dysfunction and pregnancy outcomes. IJRM 2015; 13 (7) :387-396
URL: http://ijrm.ir/article-1-667-fa.html
نظرپور سیما، رمضانی تهرانی فهیمه، سیمبر معصومه، عزیزی فریدون. اختلالات تیروئید و پیامد بارداری. International Journal of Reproductive BioMedicine. 1394; 13 (7) :387-396

URL: http://ijrm.ir/article-1-667-fa.html


1- گروه مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی شهید بهشتی، تهران، ایران
2- مرکز تحقیقات اندوکرینولوژی تولید مثل، پژوهشکده علوم غدد درون ریز و متابولیسم، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران ، ramezani@endocrine.ac.ir
3- مرکز تحقیقات غدد درون ریز و متابولیسم، پژوهشکده علوم غدد درون ریز و متابولیسم، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران
چکیده:   (6768 مشاهده)
  • حاملگی تاثیرات عمده ای بر تنظیم عملکرد تیروئید زنان سالم و مبتلا به اختلالات تیروئید دارد. شیوع اختلالات تیروئید در زنان باردار نسبتاً بالا است.
هدف: هدف بررسی حاضر، افزایش آگاهی و ارائه بررسی در مورد اثر نامطلوب اختلال عملکرد تیروئید شامل هیپوتیروئیدی ، هیپرتیروئیدی و اتوایمونیتی تیروئید بر نتایج بارداری و می باشد.
مواد و روش ها: در این بررسی مروری کتابخانه های Medline، EMBASE  وCochrane  با کلمات کلیدی مناسب برای مقاله مرتبط انگلیسی جستجو شدند. ما از انواع مطالعات، از جمله کارآزمایی بالینی تصادفی، کوهورت (آینده نگر و گذشته نگر) مطالعات مورد شاهدی، گزارش موردی استفاده کردیم. مطالعات مربوط به بیماریهای تیروئید در زنان غیر باردار و مقالات بدون کیفیت مناسب از مطالعه کنار گذاشته شدند.
نتایج: هیپرتیروئیدی و هیپوتیروئیدی آشکار دارای اثرات سوء متعددی بر نتایج بارداری می باشند. هیپرتیروئیدی آشکار با سقط، مرده زایی، زایمان زودرس، محدودیت رشد داخل رحمی، وزن کم هنگام تولد، پره اکلامپسی و اختلال عملکرد تیروئید جنین همراه بود. هیپوتیروئیدی آشکار با سقط جنین، کم خونی، فشار خون بالا ناشی از حاملگی، پره اکلامپسی، جداشدن زودرس جفت، خونریزی بعد از زایمان، تولد نوزاد نارس، وزن کم هنگام تولد، مرگ داخل رحمی ، افزایش دیسترس تنفسی نوزادان و اختلال رشد عصبی نوزاد همراه بود. با این حال عوارض هیپوتیروئیدی تحت بالینی، و آنتی بادی تیروئید مثبت بر نتایج بارداری مشخص نیست. در حالی که برخی از مطالعات شانس بیشتری برای جداشدن زودرس جفت، تولد زودرس، سقط جنین، فشارخون بالای بارداری، زجر جنین، پره اکلامپسی شدید و دیسترس و دیابت نوزادی در زنان باردار با هیپوتیروئیدی تحت بالینی یا خود ایمنی تیروئید نشان داده اند؛ در برخی مطالعات دیگر این عوارض جانبی گزارش نشده اند.
نتیجه گیری: در حالی که اثرات اختلال عملکرد تیروئید آشکار بر عوارض جنینی مادری به وضوح مشخص شده اند و تاثیر دراز مدت آن بر توسعه در دوران کودکی به خوبی شناخته شده است، با این حال عوارض زودرس و دیررس اختلال عملکرد تیروئید تحت بالینی در دوران بارداری یا بیماریهای خودایمنی تیروئید مورد بحث است. انجام مطالعات بیشتر برای شناسایی نتایج نامطلوب مادر و نوزاد در اختلالات تحت بالینی تیروئید مادر ضروری به نظر می رسد
نوع مطالعه: Original Article |

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