甲状腺功能异常与妊娠结局的关系  

The relationship between thyroid dysfunction and pregnancy outcomes in pregnant women

作　　者：王蕴慧[1] 张培[2] 赵会丹[3] 王振花[1] 陈欣[1] 张睿[1] 

机构地区：[1]中山大学孙逸仙纪念医院妇产科,广州510120 [2]中山大学附属第三医院妇产科,广州510630 [3]郑州大学附属第一医院妇产科,450052

出　　处：《中华内分泌代谢杂志》2014年第12期1058-1062,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：广东省科技计划（2011B031800119）

摘　　要：目的 了解妊娠期各种甲状腺疾病的患病率,并评估甲状腺疾病与妊娠结局的关系.方法 选取2012年3月至2014年2月在中山大学孙逸仙纪念医院产检的3 745名孕妇为研究对象,在孕期进行甲状腺功能（TT4、FT4、TSH）、甲状腺过氧化物酶抗体的检测,结果异常者定期复查,追踪妊娠结局.结果 妊娠期甲状腺疾病的患病率：甲状腺功能亢进（甲亢）1.90％,亚临床甲亢1.20％,甲状腺功能减退（甲减）1.17％,亚临床甲减6.78％,单纯低甲状腺素血症3.82％.临床甲亢组胎盘早剥发生率较正常组高（5.8％对1.0％,P＜0.01）.亚临床甲亢组妊娠期糖尿病发生率较正常组高（37.5％对16.6％,P＜0.01）.亚临床甲减组早产率较正常组高（14.3％对7.7％,P=0.002）.结论 不同类型的妊娠期甲状腺疾病可能会分别增加胎盘早剥、妊娠期糖尿病及早产的发生率.Objective The purpose of this research is to calculate the prevalence of thyroid dysfunction during pregnancy and to discuss the relationship between gestational thyroid diseases and pregnancy outcomes.Methods There were 3 745 pregnant women who took antenatal care at Sun Yat-sen Memorial Hospital,Sun Yat-sen University were chosen as the research objects during March 2012 to February 2014.All of them were given close monitoring and tracking till the termination of pregnancy.These subjects took thyroid function testing （TT4,FT4,TSH,thyroid peroxidase antibody）,if the result was abnormal,they were followed up periodically.Results The prevalence of overt hyperthyroidism is 1.90％,1.20％ for subclinical hyperthyroidism,1.17％ for hypothyroidism,6.78％ for subclinical hypothyroidism,and 3.82％ for isolated hypothyroxinemia.Compared with normal thyroid function group,the morbidity of placental abruption increased in overt hyperthyroidism group （5.8％ vs 1.0％,P＜ 0.01） ; the incidence of gestational diabetes mellitus was increased in subclinical hyperthyroidism group （37.5 ％ vs 16.6％,P＜0.01） ; and the morbidity of preterm birth increased in subclinical hypothyroidism group （14.3％ vs 7.7％,P =0.002）.Conclusion Gestational thyroid diseases may increase the incidence of adverse pregnancy outcomes ; such as placental abruption,gestational diabetes mellitus,and premature birth.

关 键 词：甲状腺功能异常 患病率 妊娠 

分 类 号：R714.256[医药卫生—妇产科学]