妊娠早期孕妇发生亚临床甲减的影响因素分析

目的调查本地区妊娠早期孕妇发生亚临床甲减(SCH)的患病情况及分析其影响因素。方法采用横断面流行病学调查方法,纳入妊娠早期孕妇2036例,按照TSH、FT4水平分为亚甲减组、正常对照组,描述两组孕妇一般情况,比较两组间实验室检测指标等因素的差异。结果2036例孕妇中亚甲减组116例(5.7%)。亚甲减组年龄、孕次、BMI的均值高于正常组,差异具有统计学意义(P<0.05)。实验室检测指标分析,亚甲减组血清TSH、TG-Ab、CHO水平高于正常组,FT4水平低于正常组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示BMIOR=2.187(1.593~3.003)]、孕次OR=2.584(1.184~5.638)]是妊娠早期发生亚临床甲减的危险因素(P<0.05);而FT4OR=0.630(0.496~0.800)]则是其保护因素(P<0.05)。结论BMI、孕次是妊娠早期亚临床甲状腺功能减退发生的独立危险因素,低水平FT4也是以后发生SCH的危险因素,应积极检测并预防,以降低不良妊娠结局的发生。

An Observation Study on the Influence Factors of Subclinical Hypothyroidism Among the First Trimester Pregnant Women

Objective To analyze the prevalence and influence factors of Subclinical hypothyroidism(SCH)among the first trimester pregnant women.Methods 2036 cases were recruited in this cross-sectional study and divided into two groups according to the serum TSH and FT4 levels:the SCH group and the normal group.Demographic variables were described and the laboratory parameters were compared between the two groups.Results Among the 2036 cases,there were 116 cases(5.7%)in the SCH group.The averages of age,body mass index(BMI),parity in the SCH group were significant higher than the normal group(P<0.05),and the averages of serum TSH,TG-Ab,and CHO in the SCH group were higher than the normal group,but serum FT4 was lower than the normal group.The differences in two groups were all statistically significant(P<0.05).Results of multivariable logistic analyze showed that BMIOR=2.187(1.593,3.003)]and parityOR=2.584(1.184,5.638)]were the risk factors of SCH(P<0.05),while FT4OR=0.630(0.496,0.800)]was the protective factor(P<0.05).Conclusion BMI and parity are the risk factors of SCH among the first trimester pregnant.Also,the low level of FT4 is the risk factor of SCH.An active detection of these indexes and early prevention will help reduce the risk of occurrence of adverse pregnancy outcome.