妊娠妇女甲状腺功能减退症及危险因素分析

目的 探讨妊娠妇女甲状腺功能减退症的流行病学特征及危险因素.方法 选取妊娠妇女2 076人及育龄妇女266人进行问卷调查和甲状腺功能、甲状腺过氧化物酶抗体(TPOAb)和尿碘测定.结果 妊娠妇女及育龄妇女甲状腺功能减退症患病率分别为5.3%及6.8%;妊娠妇女甲状腺功能减退症在高尿碘组占7.6%,高于足量尿碘组及超足量尿碘组(P=0.026),甲状腺过氧化物酶抗体(TPOAb)阳性率为23.9%,高于甲状腺功能正常者(P=0.000);多因素Logistic分析表明,高尿碘、TPOAb阳性为甲状腺功能减退症的独立危险因素,OR值分别为2.21(95%CI=1.36～3.60)及4.68(95%CI=2.74～7.98).结论 自身免疫性甲状腺疾病和过量碘摄入是妊娠妇女甲状腺功能减退症的重要因素且密切相关.

Hypothyroidism and its risk factors among pregnant women

Objective To determine the epidemiological character istics and risk factors of hypothy roidism among pregnan two men.Methods Thyroid function and urinary iodine of 2076 pregnant women and 266 women at gestational age were measured and ultrasound inspection of thyroid was conducted among the women.Results The prevalence of hypothyroidism of pregnan twomen and women at gestational age were 5 3% and 6.8%,respectively.The prevalence of hypothy roidism was 7.6% among the pregnant women with high urinary iodine,which was significantly higher than that of the adequateurinary iodine group and very high urinary iodine group(P=0.026).Positive thyroid peroxidase an tibody ratio of pregnant women in hypothy roidism group was 23.9%,which was significantly higher than those of the normal gro up(P=0.000).Multinomial lo gistic analysis showed that high urinary iodine and positive thyroid peroxidase antibody were in dependent risk factor of hypothy roidism with the oddsratio values of 221(95% confidence in te rvalCI]1.36-3.60)and 4.68(95% CI 2.74-7.98),respectively.Conclusion The autoimmune thyroiditis and iodine overdose are important factors and closely associated with hypothy roidism among pregnant women.