不同孕周干预妊娠期甲状腺功能亢进对母婴结局的影响

目的 探讨不同孕周干预妊娠期甲状腺功能亢进(甲亢)对母婴结局的影响.方法 选取2015年1月-2016年10月唐山市协和医院收治的妊娠期甲亢99例,根据实施干预时间分为A组35例,B组30例,C组34例.A组孕周＜12周,B组孕周12～ 15+6周,C组孕周16～ 20周.3组均服用甲巯咪唑.观察3组母婴结局.结果 A、B组促甲状腺激素高于C组,且A组高于B组,游离三碘甲状腺原氨酸和游离甲状腺激素水平均低于C组,且A组低于B组(P＜0.05).A组母婴不良结局发生率均低于B、C组(P＜0.05).3组不良反应发生率比较差异无统计学意义(P＞0.05).结论 对孕早期或孕前确诊的妊娠期甲亢实施早期(孕周＜12周)干预有利于减少母婴不良结局,安全性较高.

Effects of Intervention in Different Gestational Weeks on Maternal and Neonatal Outcomes in Pregnant Women with Hyperthyroidism

Objective To investigate effects of intervention of different gestational weeks on maternal and neonatal outcomes of pregnant women with hyperthyroidism.Methods A total of 99 pregnant women with hyperthyroidism admitted during January 2015 and October 2016 were divided into group A (n =35),group B (n =30) and group C (n =34) ac cording to different intervention times.Gestational week in group A was less than 12 weeks;gestational week in group B was 12-15 +6 weeks;gestational week in group C was 16-20 weeks.All pregnant women were given Methimazole,and maternal and neonatal outcomes were observed in three groups.Results In group A and B,thyroid stimulating hormone (TSH) levels were significantly higher than those in group C,and the level in group A was significantly higher than that in group B;free triiodothyronine (FT3) and free(unbound) thyroxin(e) (FT4) levels were significantly lower than those in group C,and the levels in group A were significantly lower than those in group B (P ＜ 0.05).Incidence rate of poor maternal and neonatal outcomes in group A was significantly lower than those in group B and C (P ＜ 0.05).There were no significant differences in incidence rate of adverse reactions among the three groups (P ＞ 0.05).Conclusion Early intervention (gestational week less than 12 weeks) for pregnant women with hyperthyroidism,who are confirmed in early pregnancy or progestation,is more conducive to decrease incidence rate of poor maternal and infant outcomes with good safety.