妊娠合并亚临床甲状腺功能减退症对孕产妇妊娠结局及围产儿结局的影响  

Effect of pregnancy with subclinical hypothyroidism on pregnancy outcome and perinatal outcome of pregnant women

作　　者：黄丽[1] 龚豪[1] HUANG Li GONG Haa(Department of Gynecology, Taihe Affiliated Hospital, Hubei University of Medicine, Shiyan Hubei 442000, Chin)

机构地区：[1]湖北医科大学附属太和医院妇科,湖北十堰442000

出　　处：《空军医学杂志》2017年第3期187-189,192,共4页Medical Journal of Air Force

基　　金：湖北省教育厅科学研究计划指导性项目(B2015477)

摘　　要：目的探讨妊娠合并亚临床甲状腺功能减退症对孕产妇妊娠结局及围产儿结局的影响。方法选取十堰市太和医院2013年11月—2014年12月期间妇产科122例妊娠合并亚临床甲状腺功能减退症孕妇作为观察组,另选同期140例非合并亚临床甲状腺功能减退症孕妇作为对照组。采用化学发光免疫法检测2组孕妇甲状腺激素水平,比较2组孕妇甲状腺激素水平、不良妊娠结局发生率、围产儿不良结局发生率。结果 (1)观察组孕妇三碘甲状腺原氨酸(free tririodothyroninc,FT3)、游离甲状腺素(free thyroxine,FT4)水平与对照组比较,差异无统计学意义(P>0.05);观察组孕妇促甲状腺激素(thyroid stimulating hormone,TSH)水平明显高于对照组(P<0.001);(2)观察组孕妇胎膜早破、巨大儿、先兆子痫、引产、胎儿窘迫、胎儿生长受限、产后贫血、早产的发生率显著高于对照组孕妇(P<0.05);观察组不良妊娠结局总发生率高于对照组(P<0.001);(3)观察组围产儿Apgar评分、出生体质量、终止孕周明显低于对照组;观察组围产儿不良结局发生率高于对照组(P<0.001)。结论妊娠合并亚临床甲状腺功能减退症孕妇不良妊娠结局及围产儿不良结局发生率较高,建议妊娠早期进行甲状腺功能筛查,及时进行临床治疗。Objective To investigate the effect of pregnancy complicated with subclinical hypothyroidism on pregnancy outcomes and perinatal outcomes. Methods 122 pregnant women with subclinical hypothyroidism who were admitted to our hospital between November 2013 and December 2014 were selected as the observation group, while another 140 pregnant women without subclinical hypothyroidism were selected as the control group. The levels of thyroid hormones were measured by chemiluminescence immunoassay. Thyroid hormone levels, adverse pregnancy outcomes and perinatal adverse outcomes were compared between the two groups. Results O）No significant difference was detected in FT3 and FT4 levels between the observation group and control group （P〉0.05）. The TSH level of the observation group was significantly higher than that of the control group （P〈0.001）. （-The incidence of premature rupture of membranes, macrosomia, preeclamp birth in the observation sia, induction of labor, fetal distress, fetal growth restriction, postpartum anemia and preterm group were significantly higher than those in the control group （P〈0.05）. The total incidence of adverse pregnancy outcomes in the observation group was higher than that in the control group （P〈0.001）. -Apgar score, birth weight and gestational age were significantly lower in the observation group than those in the control group （P 〈0.001）. Conclusion The incidence of adverse pregnancy outcomes and perinatal adverse outcomes in pregnant women with subclinical hypothyroidism is relatively high. It is recommended that thyroid function screening should be carried out during early pregnancy and that clinical treatment should be sought in time

关 键 词：妊娠合并亚临床甲状腺功能减退症 妊娠结局 围产儿结局 

分 类 号：R714[医药卫生—妇产科学] R581.2[医药卫生—临床医学]