STRUCTURAL AND FUNCTIONAL CHANGES IN THE THYROID GLAND INSTALLED DURING THE GESTATION PERIOD
Abstract
Background. Iodine deficiency is one of the most common non-communicable diseases in humans. Diseases of the thyroid gland in its prevalence occupy a dominant place among endocrinopathy, among which a special place is occupied by autoimmune diseases, nodular forms, malignant tumors and iodine deficiency. Women of reproductive age predominate in the structure of thyroid disease incidence. Materials and methods. The analysis of the data of examination of the state of the thyroid gland of pregnant women who are registered in the state budgetary institution of health care institution of the Leningrad region “Perinatal Center”, Gatchina, was carried out. The survey consisted of analysis of medical documentation, survey, inspection endocrinologist, ultrasonic research of thyroid, study of hormonal. Results. Thyroid pathology was identified in 15.8–16.0 % of pregnant women. There was an increase in autoimmune thyroiditis in the structure of thyroid pathology with each subsequent year analyzed. In 2020, a 2-fold decrease in the number of patients examined was established due to the unavailability of planned outpatient care during the coronavirus pandemic. In the indicated year, an increase in the frequency of detection of diffuse non-toxic goiter in combination with hypothyroidism was found, with a natural decrease in the number of cases without impaired thyroid function and a decrease in the proportion of patients with nodular goiter. Conclusion. Given the high prevalence of thyroid disease in pregnant women of St. Petersburg and Leningrad region, it is advisable to search for endocrinopathy in women of reproductive age when planning pregnancy and necessarily in the I trimester, up to 10–12 weeks of gestation. Carrying out preparation and control of thyroid status throughout the gestation period prevents the development of goiter in women, normalizes the function of thyroid and prevents violations that are possible in both women and the fetus.
References
Андрюков Б.Г., Гвозденко Т.А., Демьяненко Н.Б. Избыток йода в организме — экологический фактор риска развития аутоиммунных заболеваний щитовидной железы? Здоровье. Медицинская экология. Наука. 2015; 2(60): 6–16.
Баладжанова А.Б., Зотова М.Д., Алиева А.Я. Структура тиреоидной патологии у беременных. Bulletin of medical internet conferences. 2014; 4(5): 518.
Данилова Л.А., Башарина О.Б., Красникова Е.Н. и др. Справочник по лабораторным методам исследования. М.: Питер; 2003.
Зайчик А.Ш., Васильев А.Г. Патохимия (эндокринно-метаболические нарушения). СПб.: ЭЛБИ-СПб; 2007.
Квиткова Л.В., Зинчук С.Ф., Затолокина Е.Н. Проблема йодного дефицита у жителей сельского региона. Сибирский медицинский журнал. 2009; 1: 70–2.
Кузнецов Е.В., Жукова Л.А., Пахомова Е.А., Гуламов А.А. Эндокринные заболевания как медико-социальная проблема современности. Современные проблемы науки и образования. 2017; 4. URL: https://science-education.ru/ru/article/view?id = 26662 (дата обращения: 13.03.2022).
Лабыгина А.В., Загарских Е.Ю., Даржаев З.Ю., Шипхинеева Т.И. Заболевания щитовидной железы и репродуктивное здоровье женского населения основных этнических групп Восточной Сибири. Бюллетень Восточно-Сибирского научного центра Сибирского отделения Российской академии медицинских наук. 2013; 4(92): 41–5.
Луценко Л.А. Патология щитовидной железы у женщин репродуктивного возраста: преконцепционная подготовка и тактика ведения во время беременности. Клиническая тиреоидология. 2015; 2(66): 111–6.
Ляхнович Н.А. Влияние патологии щитовидной железы на течение беременности. Журнал ГрГМУ. 2008; 4: 62–5.
Медяник М.И., Похлебкина А.А., Мильнер Е.Б. Ожирение и щитовидная железа. Некоторые механизмы взаимосвязи. Университетский терапевтический вестник. 2021; 3(2): 13–24.
Павлова Т.В., Малютина Е.А., Петрухин В.А. Влияние патологии щитовидной железы на течение беременности и родов. Литературный обзор. Фундаментальные исследования. 2011; 3: 15–21.
Перминова С.Г. Патология щитовидной железы у женщин с бесплодием. Клиническая и экспериментальная тиреоидология. 2011; 4(7): 44–50.
Платонова Н.М. Йодный дефицит: современное состояние проблемы. Клиническая и экспериментальная тиреоидология. 2015; 1(11): 12–21. DOI: 10.14341/ket2015112-21.
Строев Ю.И., Соболевская П.А., Чурилов Л.П., Утехин В.И. Роль гипокальциемии и витамина D3 в патогенезе фобий при хроническом аутоиммунном тироидите Хасимото. Педиатр. 2017; 8(4): 39–42. DOI: 10.17816/PED8439-42.
Andersen S.L., Andersen S., Liew Z. et al. Maternal thyroid function in early pregnancy and neuropsychological performance of the child at 5 years of age. J Clin Endocrinol Metab. 2018; 103(2): 660–70. DOI: 10.1210/jc.2017-02171.
Carney L.A., Quinlan J.D., West J.M. Thyroiddisease in pregnancy. Am Fam Physician. 2014; 89(4): 273–8.
Hales C., Taylor P.N., Channon S. et al. Controlled antenatal thyroid screening II: effect of treating maternal suboptimal thyroid function on child cognition. J Clin Endocrinol Metab. 2018; 103(4): 1583–91. DOI: 10.1530/ey.15.3.5
Johns L.E., Ferguson K.K., Cantonwine D.E. et al. Subclinical changes in maternal thyroid function parameter sin pregnancy and fetal growth. J Clin Endocrinol Metab. 2018; 103(4): 1349–58. DOI: 10.1210/jc.2017-01698.
Jølving L.R., Nielsen J., Kesmodel U.S. et al. Chronic diseases in the children of women with maternal thyroid dysfunction: a nationwide cohort study. Clin Epidemiol. 2018; 10: 1381–90. DOI: 10.2147/CLEP.S167128.
Kolesnikova L.I., Darenskaya M.A., Grebenkina L.A. et al. Features of compensatory-adaptive reactions of an organism in female representatives of the evenk ethnos. Journal of Evolutionary Biochemistry and Physiology. 2016; 52: 440–5. DOI: 10.1134/S1234567816060021.
Kolesnikova L.I., Darenskaya M.A., Grebenkina L.A. et al. Indicators of pituitary-thyroid system and lipid metabolism in female representatives of the Buryat ethnos and Europeoids. J Evol Biochem Phys. 2016; 52: 299–304. DOI: 10.1134/S0022093016040049.
Korevaar T.I., Muetzel R., Medici M. et al. Association of maternal thyroid function during early pregnancy with offspring IQ and brain morphology in childhood: a population-based prospective cohort study. Lancet Diabetes Endocrinol. 2016; 4(1): 35–43. DOI: 10.1016/S2213-8587(15)00327-7.
Korevaar TIM., Medici M., Visser T.J., Peeters R.P. Thyroid disease in pregnancy: new insights in diagnosis and clinical management. Nat Rev Endocrinol. 2017; 13(10): 610–22. DOI: 10.1038/nrendo.2017.93.
Loubière L.S., Vasilopoulou E., Glazier J.D. et al. Expression and function of thyroid hormone transporters in the microvillous plasma membrane of human term placental syncytiotrophoblast. Endocrinology. 2012; 153(12): 6126–35. DOI: 10.1210/en.2012-1753.
Promintzer-Schifferl M., Krebs M. Thyroid disease in pregnancy: Review of current literature and guidelines. Wien Med Wochenschr. 2019. DOI: 10.1007/s10354-018-0680-9
Seo G.H., Kim T.H., Chung J.H. Antithyroid drugs and congenital malformations: a nationwide Korean cohort study. Ann InternMed. 2018; 168(6): 405–13. DOI: 10.1530/ey.15.3.9.
Turunen S., Vääräsmäki M., Männistö T. et al. Pregnancy and perinatal outcome among hypothyroid mothers: a population based cohort study. Thyroid. 2019; 29(1): 135–41. DOI: 10.1089/thy.2018.0311.
van Dijk M.M., Smits I.H., Fliers E., Bisschop P.H. Maternal thyrotropin receptor antibody concentration and the risk of fetal and neonatal thyrotoxicosis: a systematic review. Thyroid. 2018; 28(2): 257–64. DOI: 10.1089/thy.2017.0413.
