بررسی تأثیر درمان با لووتیروکسین در مادران مبتلا به اختلالات تیروئیدی بر تکامل روان‌شناختی کودکان، مرور سیستماتیک

نوع مقاله: مروری

نویسندگان

1 استادیار گروه مامایی، دانشکده پزشکی، دانشگاه آزاد اسلامی، واحد ورامین- پیشوا، تهران، ایران. مرکز تحقیقات اندوکرینولوژی تولید مثل، پژوهشکده غدد درون‌ریز، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

2 استاد گروه اندوکرینولوژی تولید مثل، مرکز تحقیقات اندوکرینولوژی تولید مثل، پژوهشکده غدد درون‌ریز، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 استاد گروه اندوکرینولوژی، مرکز تحقیقات اندوکرینولوژی، پژوهشکده علوم غدد درون‌ریز، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: مطالعات متعددی ارتباط بین اختلالات تیروئید مادران در دوران بارداری و اختلالات عصبی در کودکان را مورد بررسی قرار داده‌اند و نقش قابل توجه هورمون‌های تیروئیدی مادر در تمام مراحل رشد سلول‌های مغزی کودکان غیرقابل انکار می‌باشد. علی‌رغم مطالعات انجام شده، هنوز در مورد اینکه آیا درمان با لووتیروکسین در نارسایی هورمون تیروئید مادر باعث بهبود نتایج تکامل عصبی در کودکان می‌شود، اطمینان کافی وجود ندارد.مطالعه مرور سیستماتیک حاضر با هدف بررسی اثر درمان با لووتیروکسین در زنان باردار مبتلا به اختلالات تیروئیدی بر تکامل عصبی کودکان انجام شد.
روشکار: در این مطالعه مرور سیستماتیک، پایگاه‌های PubMed، Web of Science، Wiley،Google Scholar، Science direct و Scopus databases از سال 2019-1950 برای یافتن مقالات مرتبط انگلیسی با کلمات ‌کلیدی مناسب مورد جستجو قرار گرفتند. در این بررسی از انواع مطالعات از قبیل کارآزمایی بالینی تصادفی شده، کوهورت، مورد شاهدی و گزارش موردی استفاده گردید. از بین 343 مقاله مرتبط در جستجوی اولیه، در نهایت 9 مطالعه واجد شرایط مورد ارزیابی قرار گرفتند.
یافتهها: از 9 مطالعه انجام شده در این زمینه، 7 مطالعه نشان دادند که تجویز لووتیروکسین به مادران مبتلا به اختلالات تیروئیدی، هیچ تأثیر معنی‌داری بر عملکرد شناختی کودکان و یا سایر شاخص‌های توسعه عصبی ندارد و تنها در یک مطالعه گزارش موردی و یک مطالعه با 13 نمونه مورد بررسی، درمان منجر به بهبود تکامل هوشی عصبی کودکان شده بود.
نتیجهگیری: درمان با لووتیروکسین در زنان باردار مبتلا به اختلالات تیروئید، تأثیری بر بهبود تکامل عصبی کودکان ندارد.

کلیدواژه‌ها


عنوان مقاله [English]

The effects of levothyroxine treatment in mothers with thyroid dysfunction on children's neurocognitive development: systematic review

نویسندگان [English]

  • Sima Nazarpour 1
  • Fahimeh Ramezani Tehrani 2
  • Fereidoun Azizi 3
1 Assistant Professor, Department of Midwifery, Faculty of Medicine, Islamic Azad University, Varamin-Pishva Branch, Tehran, Iran. Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Professor, Department of Reproductive Endocrinology, Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Professor, Department of Endocrinology, Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Several studies have evaluated the association between maternal thyroid dysfunction during pregnancy and neurocognitive development in children. The important role of maternal thyroid hormones in all stages of the brain development in children is undeniable. Despite performed studies, there is still insufficient evidence on the beneficiary effect of the levothyroxine treatment in pregnant women with thyroid dysfunctions in terms of neurodevelopmental outcomes of children. This systematic review was performed with aim to evaluate the effects of treatment with levothyroxine in pregnant women with thyroid dysfunctions on neurocognitive development in children.
Methods: In this systematic review, databases of PubMed, Web of Science, Wiley, Google Scholar, Science Direct and Scopus were searched with appropriate keywords for the English related article from 1950 to 2019. This study used randomized clinical trials, cohort, case-control studies and case report. Among 343 related articles in initial search, 9 eligible studies were finally evaluated.
Results: From 9 studies in this field, seven studies showed that administration of levothyroxine in mothers with thyroid dysfunctions had no significant effect on children's cognitive function or other neurodevelopment indicators; only a case report and a study on 13 samples showed that treatment improved the children neurocognetive indicators.
Conclusions: Treatment with levothyroxine in pregnant women with thyroid dysfunctions has no significant effect on neurodevelopment of children.

کلیدواژه‌ها [English]

  • Hypothyroidism
  • Levothyroxine
  • neurodevelopment
  • Offspring
  • pregnancy
  • Thyroid dysfunction
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