妊娠合并甲状腺功能减退患者妊娠结局及妊娠期并发症情况临床研究

目的探讨妊娠合并甲状腺功能减退患者的妊娠结局及妊娠期并发症情况。方法选取2016年11月-2018年11月期间临海市第二人民医院收治的90例妊娠合并甲状腺功能减退患者作为研究组,根据治疗情况将甲状腺功能减退患者分为甲状腺功能减退治疗组(43例)和甲状腺功能减退未治疗组(47例),同时选取45例健康妊娠妇女作为对照组。比较3组妊娠结束时甲状腺指标的变化情况,记录3组妊娠结局、胎儿情况和妊娠期并发症的发生率。结果甲状腺功能减退未治疗组患者血清甲状腺过氧化物酶抗体和促甲状腺激素(TSH)水平明显高于对照组(P<0.05),游离甲状腺素(FT4)明显低于对照组(P<0.05)。甲状腺功能减退未治疗组患者不良妊娠结局和并发症的发生率明显高于对照组,且胎儿窘迫、胎儿畸形、死胎、胎儿生长受限的发生率亦明显高于对照组(P<0.05)。但经过治疗后的甲状腺功能减退患者不良妊娠结局发生率、并发症发生率及胎儿出生情况与对照组比较,差异均无统计学意义(均P>0.05)。结论妊娠合并甲状腺功能减退可造成不良的妊娠结局,对胎儿具有不良影响,并产生一系列并发症。因此在孕早期应对孕产妇进行常规甲状腺筛查,改善妊娠结局。

Clinical study on pregnancy outcome and pregnancy complications in hypothyroidism patients

Objective To study the pregnancy outcome and pregnancy complications in hypothyroidism patients.Methods 90 patients with hypothyroidism during pregnancy admitted to our hospital from November 2016 to November 2018 were selected as the experimental group.Patients with hypothyroidism were divided into the hypothyroidism treatment group(n=43)and the untreated group(n=47)according to the treatment situation,and 45 healthy pregnant women in the same period were selected as the control group.The changes of thyroid indexes at the end of pregnancy in the three groups were compared,and the pregnancy outcome,fetal condition and the incidence of pregnancy complications in the three groups were also recorded.Results Serum levels of thyroid peroxidase antibody and TSH in the untreated hypothyroidism group were significantly higher than those in the control group(P<0.05),and free thyroxine was significantly lower than those in the control group(P<0.05).The incidence of adverse pregnancy outcomes and complications was significantly higher in the untreated group than in the control group,and the incidence of fetal distress,fetal malformation,stillbirth,and fetal growth restriction was also significantly higher in the untreated group than in the control group(P<0.05).However,after treatment,the incidence of adverse pregnancy outcomes,complications and fetal birth in hypothyroidism patients were not significantly different from the control group(P>0.05).Conclusion Pregnancy with hypothyroidism may lead to adverse pregnancy outcomes,adverse effects on the fetus,and a series of complications.Therefore,routine thyroid screening should be carried out in early pregnancy to improve pregnancy outcomes.