孕早期亚临床甲状腺功能减退及年龄与早产的相关性研究

目的分析年龄及孕早期亚临床甲减(SCH)与早产及其亚型的相关性,为不同年龄孕早期亚甲减患者孕期监测制定个体化策略提供科学依据。方法以2016年2月-2018年6月在甘肃省妇幼保健院高危产科产检的单胎活产孕妇2868例为研究对象,使用Logistic回归模型分别分析年龄及孕早期亚甲减与早产的相关性。结果控制混杂因素后,与适龄孕妇相比,高龄孕妇(≥35岁)发生早产风险增加0.67倍(OR=1.67,95%CI:1.32~2.13);年龄较小孕妇发生早期/极早期早产风险升高2.65倍(OR=3.65,95%CI:2.21~6.05)。与甲功正常孕妇相比,亚甲减孕妇发生早产风险增加2.07倍(OR=3.07,95%CI:2.28~4.12)、发生中晚期早产风险增加1.67倍(OR=2.67,95%CI:1.86~3.83)。交互作用分析显示,年龄与亚临床甲减对早产的发生风险存在相乘的交互作用。结论不同年龄亚甲减孕妇发生早产及其亚型的风险不一致。建议对孕早期亚甲减患者应根据年龄进行风险分层,开展个体化孕期管理和用药指导。

Study on the correlation of preterm birth with subclinical hypothyroidism and age of pregnant women

Objective To investigate the association of preterm birth with pregnant women age and subclinical hypothyroidism (SCH), in order to provide scientific evidence for making individualized strategies for pregnant women with SCH. Methods A total of 2 868 pregnant women in Gansu Provincial Maternity and Child Care Hospital were enrolled in this study from February 2016 and June 2018. Unconditional Logistic regression model was used to evaluate the associations between age, SCH and the risk of preterm birth. Results Compared with moderate age women, women of advanced reproductive age had higher risk of preterm birth (OR=1.67,95%CI: 1.32-2.13). Younger women had higher risk for very preterm birth (OR=3.65, 95%CI: 2.21-6.05).Compared with women with normal thyroid function, women with SCH had higher risk of preterm birth and moderate preterm birth (preterm birth,OR=3.07, 95%CI:2.28-4.12; moderate preterm birth OR=2.67, 95%CI:1.86-3.83).Interaction analysis revealed a multiplier interaction between age and SCH on the risk of preterm birth. Conclusions The risk of preterm birth and its subtypes in SCH patients of different ages is not consistent. It is suggested to assess preterm risk in SCH women by different age groups and take individualized pregnancy management and medication guidance.