妊娠合并甲状腺功能减退产妇分娩前后TSH浓度及分娩结局分析  

Analysis of TSH concentration before and after delivery and delivery outcome in pregnant women with hypothyroidism

作　　者：李灵玲[1] 肖准[2] LI Lingling;XIAO Zhun(Maternal and Child Health Care Hospital of Sichuan Province,Chengdu 610045,Sichuan,China;Huaxi Second Hospital,Siehuan University,Chengdu 610041,Siehuan,China)

机构地区：[1]四川省妇幼保健院,四川成都610045 [2]四川大学华西第二医院,四川成都610041

出　　处：《现代中西医结合杂志》2018年第23期2540-2542,2546,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的探讨妊娠合并甲状腺功能减退对妊娠结局和胎儿的影响。方法收集住院分娩的孕妇375例,分为甲减组92例、亚甲减组133例和正常对照组150例,回顾性分析所有孕妇的临床资料,比较3组妊娠结局和胎儿结局。结果甲减组和亚甲减组孕产妇分娩前及分娩后1周血TSH浓度明显高于正常对照组(P均<0.05);正常对照组孕妇贫血、早产发生率均低于甲减组和亚甲减组,正常对照组孕妇胎膜早破发生率低于甲减组,差异均有统计学意义(P均<0.05),3组间前置胎盘、胎盘早剥、羊水量异常及产后出血发生率比较差异均无统计学意义(P均>0.05);正常对照组低出生体质量、胎儿窘迫发生率明显低于甲减组和亚甲减组,而出生体质量、Apgar评分明显高于甲减组和亚甲减组,差异均有统计学意义(P均<0.05)。结论妊娠合并甲状腺功能减退可对妊娠结局和胎儿产生不利影响,临床上应加强妊娠期甲状腺功能检查,早发现早治疗。Objective It is to explore the effect of hypothyroidism during pregnancy on pregnancy outcome and fetus.Methods 375 cases of pregnant women were selected and divided into hypothyroidism group with 92 cases,subclinical hypothyroidism group with 133 cases and normal control group with 150 cases. The clinical data of all pregnant women were analyzed retrospectively,and the pregnancy outcomes and fetal outcomes were compared among the three groups. Results The concentration of serum TSH before and 1 weeks after delivery in hypothyroidism group and subclinical hypothyroid group were higher than that in normal control group（ P〈0. 05）; The incidence of anemia and premature birth in normal control group was lower than that in hypothyroidism group and subclinical hypothyroidism group（ P〈0. 05）,and the incidence of premature rupture of membranes in normal control group was lower than that in hypothyroidism group（ P〈0. 05）;There was no significant difference in the incidence of placenta previa,placental abruption,amniotic fluid volume and postpartum hemorrhage among the three groups（ P〉0. 05）; The incidence of low birth weight and fetal distress in normal control group was lower than that in hypothyroidism group and subclinical hypothyroidism group,but the birth weight and Apgar score were higher than that in hypothyroidism group and subclinical hypothyroidism group（ P〈0. 05）. Conclusion Hypothyroidism during pregnancy have adverse effects on pregnancy outcomes and the fetus. It is necessary to strengthen thyroid function examination during pregnancy for early detection and early treatment.

关 键 词：妊娠期甲状腺功能减退 血清促甲状腺素 产科并发症 胎儿结局 

分 类 号：R581.04[医药卫生—内分泌]