妊娠期特异性甲状腺功能参考值范围建议与分析OA

Objective To establish trimester-specific reference ranges for thyroid function in pregnant women in the Shijiazhuang area,providing a basis for precise clinical evaluation and intervention.Methods A prospective longitudinal sequential study was conducted.A total of 120 women with singleton pregnancies(observation group)at the Second Hospital of Hebei Medical University from January 2022 to December 2023 were enrolled.Serum levels of thyroid-stimulating hormone(TSH),free thyroxine(FT4),free triiodothyronine(FT3),total thyroxine(TT4),and total triiodothyronine(TT3)were measured in the first,second,and third trimesters respectively.A concurrent control group consisting of 120 healthy non-pregnant women of childbearing age was recruited,and reference ranges were established.Results During pregnancy,TSH levels increased with gestational age(1.22,1.31,and 1.61 mU/L in the first,second,and third trimesters,respectively),while FT4 and FT3 levels decreased(FT4 was 15.62 pmol/L in the first trimester,declining to 12.15 pmol/L in the third trimester).The levels of TSH,FT4,and FT3 in all trimesters were significantly different from those in the control group(P＜0.05).TT4 and TT3 levels in each trimester in the observation group were higher than those in the control group(P＜0.05),with TT4 peaking in the second trimester.The upper limits of TSH reference ranges established in this study(3.80 mU/L in the first trimester,3.51 mU/L in the second trimester and 4.01 mU/L in the third trimester)were higher than those recommended by the ATA guidelines.Conclusion The trimester-specific reference ranges for thyroid function in the Shijiazhuang area exhibit significant regional specificity.Establishing localized reference ranges can reduce misdiagnosis and provide scientific support for the management of thyroid disorders during pregnancy.