妊娠期亚临床甲状腺功能减退症对妊娠结局和胎儿不良影响研究  

Analysis of the effect of subclinical hypothyroidism in pregnancy on pregnancy outcome and fetal adverse effects

作　　者：房秋霞[1] 舒展[1] 杨金铭[1] 马恩萍 毛艳丽[1] Fang Qiuxia;Shu Zhan;Yang Jinming(Department of Gynecology,Xiehe Hospital of Tangshan City in He bei Province,Tangshan 063000)

机构地区：[1]河北省唐山市协和医院妇产科,唐山063000

出　　处：《陕西医学杂志》2018年第3期338-340,343,共4页Shaanxi Medical Journal

基　　金：河北省卫生和计划生育委员会科研项目(20150996)

摘　　要：目的:研究妊娠期亚临床甲状腺功能减退症对妊娠结局和胎儿造成的不良影响。方法:选择亚临床甲状腺功能减退孕产妇127例(亚甲减组)以及同时期甲状腺功能正常孕妇420例(对照组)。两组孕妇分别于妊娠早期(孕12周)、中期(孕24周)、晚期(孕36周)和产后6周空腹采取静脉血3ml行甲状腺功能检查,测定TSH、FT_4、TPOAb值,根据检查结果指导患者用药。比较两组孕妇的妊娠结局和胎儿结局。结果:亚甲减组孕产妇的妊娠期糖尿病、妊娠期高血压、流产、早产、产后出血的发生率显著高于对照组,差异有统计学意义(P<0.05)。两组孕产妇的胎膜早破和剖宫产的发生率比较差异无统计学意义(P>0.05)。亚甲减组胎儿窘迫、胎儿生长低下、低出生体重以及先兆子痫的发生率显著高于对照组,差异有统计学意义(P<0.05)。两组新生儿的畸形发生率比较差异无统计学意义(P>0.05)。结论:妊娠期亚临床甲状腺功能减退症可诱发不同形式的并发症,对妊娠结局和胎儿结局产生了不良影响。Objective:To study the effect of subclinical hypothyroidism in pregnancy on pregnancy outcome and fetal adverse effects.Methods:thyroid function from decreased for maternal 127 cases(subclinical hypothyroidism group)and thyroid function in 420 cases of normal pregnant women(control group),two groups of pregnant women in early pregnancy(12 gestational weeks),middle(24 weeks gestation)and late stage(36 weeks gestation)and 6 weeks postpartum took fasting venous blood 3ml for thyroid function tests,determination of TSH,FT4,TPOAb,according to the examination results of patients with clinician patient medication guide.The pregnancy outcome and fetal outcome were compared between the two groups.Results:subclinical hypothyroidism group maternal gestational diabetes,gestational hypertension,abortion,premature delivery,postpartum hemorrhage rate was significantly higher than the control group,the difference was statistically significant(P<0.05).There was no significant difference between the two groups in the incidence of premature rupture of membranes and the incidence of uterine incision(P>0.05).Subclinical hypothyroidism group,fetal distress,fetal growth retardation,low birth weight and the incidence of preeclampsia was significantly higher than the control group,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of malformation between the two groups(P>0.05).Conclusion:subclinical hypothyroidism in pregnancy can induce different types of complications,and have adverse effects on pregnancy outcome and fetal outcome.

关 键 词：妊娠期甲状腺功能减退症/并发症 胎儿发育 妊娠结局 婴儿 早产 

分 类 号：R714.2[医药卫生—妇产科学]