妊娠期甲状腺疾病对胎儿宫内生长发育的影响  

Effects of thyroid diseases during pregnancy on fetal growth and development

作　　者：张珊珊 Zhang shanshan(The Maternal and Child Health Hospital of Nanshan,Shenzhen 518000,China)

机构地区：[1]深圳市南山区妇幼保健院产科,广东深圳518000

出　　处：《中国产前诊断杂志（电子版）》2021年第1期47-50,共4页Chinese Journal of Prenatal Diagnosis(Electronic Version)

摘　　要：目的探讨妊娠期甲状腺疾病对胎儿宫内生长发育的影响。方法采用前瞻性研究方法,随机纳入2020年1月至2020年12月在深圳市南山区妇幼保健院产科分娩的孕妇550例,并在孕妇早、中、晚期检测甲状腺素水平以及甲状腺过氧化物酶抗体,记录孕妇发生甲状腺功能减低(简称:甲低)、甲状腺功能亢进(简称:甲亢)的发生率,并进行分组,分为亚临床甲减组、低甲状腺素血症组(甲低组)、甲状腺功能正常组、单纯甲状腺过氧化物酶抗体阳性组(TPO-Ab阳性组)、甲状腺功能亢进组(甲亢组),记录各孕期下甲状腺疾病对胎儿生长发育的影响。结果在孕早期,共13.64%孕妇出现甲低、15.64%出现亚临床甲减,11.82%出现TPO-Ab阳性,但无甲亢病例,孕中期和孕晚期甲低的发生率为7.81%、0.82%,而TPO-Ab阳性率分别为6.48%、6.77%,甲亢发生率分别为8.76%和9.16%。妊娠晚期,甲低和甲亢组的胎儿双顶径、头围、股骨长、出生体重、出生身长均明显低于正常组(P<0.05),胎龄亦明显降低,但TPO-Ab阳性组和正常组比较差异未见统计学差异(P>0.05)。妊娠晚期甲低、甲亢孕妇均合并不同程度的不良妊娠结局,其早产率、低体质量儿出生率、胎儿生长受限率、胎儿宫内窘迫率和新生儿窒息发病率、均较正常孕妇显著升高,组间比较差异具有统计学意义(P<0.05)。结论在妊娠早期检测甲状腺素水平,即可早期评估胎儿生长发育情况,妊娠期甲状腺功能异常均可对妊娠结局和新生儿预后产生不良影响,早期纠正甲状腺功能对改善妊娠结局具有重要的意义。Objective To investigate the influence of thyroid diseases during pregnancy on fetal growth and development.Methods prospective study method,random into The Maternal and Child Health Hospital of Nanshan from January 2020 to December 2020 in our hospital 550 cases of pregnant women,obstetric delivery and thyroxine in the early,middle and late pregnant women testing levels and thyroid peroxidase antibody,record the pregnant woman JiaJian,the incidence of hyperthyroidism,and grouping,divided into subclinical JiaJian group,low thyroid hormone levels(a low group)and normal thyroid function group,the pure thyroid peroxidase antibody positive group(TPO-Ab positive group),thyroid function hyperfunction group(hyperthyroidism),records of thyroid disease during pregnancy on fetal growth and development.Results In the early stage of pregnancy,13.64%of the pregnant women had low grade A,15.64%had subclinical hypothyroidism,11.82%had TPO-AB positive,and 7.81%and0.82%had low grade A in the second and third stages of pregnancy,while 6.48%and 6.77%had TPOAB positive,and 8.76%and 9.16%had hyperthyroidism,respectively.In the third trimester of pregnancy,the fetal double parietal diameter,head circumference,femur length,birth weight and birth body length were significantly lower in the low and hyperthyroidism groups than in the normal group(P<0.05),and the gestational age was also significantly reduced,but there was no statistical difference between the tpo-ab positive group and the normal group(P>0.05).Low a and hyperthyroidism in the third trimester of pregnancy were associated with different degrees of adverse pregnancy outcomes,and the rate of preterm birth,low body mass birth rate,fetal growth restriction rate,fetal intrauterine distress rate and neonatal asphyxia incidence were significantly higher than that of normal pregnant women,with statistically significant differences between groups(P<0.05).Conclusions Detection of thyroxine level in early pregnancy can assess fetal growth and development at an early stage.Abnormal thyr

关 键 词：妊娠期 甲状腺疾病 胎儿宫内生长发育 

分 类 号：R714.256[医药卫生—妇产科学]