妊娠期亚临床甲状腺功能减退症与妊娠结局的相关性

目的 探讨妊娠期亚临床甲状腺功能减退症(亚临床加减)与妊娠结局的相关性.方法 选取2012年9月至2015年9月在我院产检孕妇2362例,行孕期甲状腺功能筛查(促甲状腺激素TSH、游离甲状腺素FT4及甲状腺过氧化物酶抗体TPOAb),其中亚临床甲减孕妇134例为观察组,同期就诊的正常孕妇169例为对照组,观察两组孕妇妊娠结局并比较分析.结果 妊娠合并甲状腺疾病患病率为12.62%(298/2362),其中亚临床甲减患病率为5.67%(134/2362),占甲状腺疾病的44.97%(134/298),亚临床甲减患者中TPOAb阳性率为42.54%(57/134).观察组孕妇的流产、妊娠期糖尿病、早产、妊娠期高血压、产后出血、胎儿窘迫、胎儿生长受限发生率分别为7.46%(10/134)、15.67%(21/134)、9.70%(13/134)、7.46%(10/134)、10.45%(14/134)、12.69%(17/134)、8.21%(11/134),高于对照组的1.78%(3/169)、7.10%(12/169)、2.96%(5/169)、2.37%(4/169)、4.73%(8/169)、4.73%(8/169)、2.96%(5/169),差异均有统计学意义(P<0.05);观察组孕妇的胎膜早破、剖宫产、胎儿畸形发生率分别为22.39%(30/134)、26.87%(16/134)、0.75%(1/134),虽然略高于对照组20.12%(34/169)、26.63%(45/169)、0(0/169),但差异无统计学意义(P>0.05).结论 妊娠合并亚临床甲减可导致多种不良妊娠结局,加强对孕妇甲状腺功能筛查并给予相应治疗,可有效改善妊娠结局.

Analysis of the relationship between subclinical hypothyroidism in pregnancy and pregnancy outcome

Objective To investigate the relationship between subclinical hypothyroidism in pregnancy and pregnancy outcome. Methods A total of 2362 pregnant women in our hospital for prenatal testing from Sep. 2012 to Sep. 2015 were selected, which underwent thyroid function screening in pregnancy, including thyroid stimulating hor-mone (TSH), free thyroxine (FT4) and thyroid peroxidase antibody (TPOAb). Among the 2362 pregnant women, 134 with subclinical hypothyroidism were selected as the observation group, and 169 normal pregnant women were enrolled as the control group. The pregnancy outcomes of two groups were observed and compared. Results The prevalence of thyroid diseases in pregnancy was 12.62% (298/2362), of which the prevalence of subclinical hypothyroidism was 5.67%(134/2362), accounting for 44.97%(134/298) of thyroid diseases. In the patients with subclinical hypothyroid-ism, TPOAb positive rate was 42.54% (57/134). The incidences of abortion, gestational diabetes, postpartum hemor-rhage, prematurity, gestational hypertension, postpartum hemorrhage, fetal distress, fetal growth restriction were signifi-cantly higher in the observation group than the control group [7.46%(10/134) vs 1.78%(3/169), 15.67%(21/134) vs 7.10%(3/169), 9.70%(13/134) vs 2.96%(5/169), 7.46%(10/134) vs 2.37%(4/169), 10.45%(14/134) vs 4.73%(8/169), 12.69%(17/134) vs 4.73%(8/169), 8.21%(11/134) vs 2.96%(5/169), P<0.05]. The incidences of premature rupture of mem-branes, cesarean section, fetal malformation in the observation group were slightly higher than those in the control group [22.39%(30/134) vs 20.12%(34/169), 26.87%(36/134) vs 26.63%(45/169), 0.75%(1/134) vs 0(0/169)], with no statistically significant difference (P>0.05). Conclusion Pregnant women with subclinical hypothyroidism can lead to a variety of adverse pregnancy outcomes. Strengthening the screening of thyroid function in pregnant women and giving the corresponding treatment can effectively improve pregnancy outcome.