478例妊娠期甲状腺功能减退症病例分析  

Analysis of 478 cases of hypothyroidism during pregnancy

作　　者：成志[1] 温穗文[1] 陈玉铃 付宏望 孙晶[1] 蔡莉花 CHENG Zhi;WEN Sui-wen;CHEN Yu-ling(Qingyuan People's Hospital,Sixth Affiliated Hospital of Guangzhou Medical University,Qingyuan 511500,China)

机构地区：[1]广州医科大学附属第六医院清远市人民医院,511500

出　　处：《中国现代药物应用》2022年第24期50-53,共4页Chinese Journal of Modern Drug Application

基　　金：2018年清远市社会发展领域自筹经费科技计划项目(项目编号:2018B069)。

摘　　要：目的分析妊娠期甲状腺功能减退症(甲减)患者的妊娠结局,同时探讨高危因素与妊娠结局之间的关系。方法回顾性分析478例单胎妊娠期甲减患者的病例资料,其中高龄(≥35岁)患者82例(17.15%)、妊娠糖尿病(GDM)患者91例(19.04%)、体外授精(IVF)患者44例(9.21%)、子痫患者20例(4.18%);羊水过少、新生儿高胆红素血症、胎儿窘迫、新生儿窒息、胎儿生长受限(FGR)、早产、剖宫产分别为20例(4.18%)、100例(20.92%)、37例(7.74%)、11例(2.30%)、21例(4.39%)、28例(5.86%)、188例(39.33%)。统计整理患者的临床资料及妊娠结局,比较不同特征患者的分娩方式;分析各高危因素之间的相关性,各高危因素和分娩结局的相关性;比较不同高危因素患者的新生儿体重。结果剖宫产患者的年龄大于顺产患者,差异具有统计学意义(P<0.05);子痫患者剖宫产率最高,剖宫产患者中高龄、子痫占比均高于顺产,差异具有统计学意义(P<0.05);不同合并高危因素数量患者的剖宫产率比较差异有统计学意义(P<0.05),剖宫产率随着合并高危因素数量的增加而升高。剖宫产患者的GDM、IVF占比与顺产患者比较,差异无统计学意义(P>0.05)。妊娠期甲减患者中高龄与GDM和子痫正相关(r=0.147、0.099,P<0.05),IVF和子痫正相关(r=0.186,P<0.05)。妊娠期甲减患者中,高龄与胎儿窘迫负相关(r=-0.090,P<0.05),与剖宫产正相关(r=0.146,P<0.05);GDM与早产正相关(r=0.174,P<0.05);IVF与胎儿窘迫正相关(r=0.097,P<0.05);子痫与胎儿窘迫、FGR、早产、剖宫产正相关(r=0.096、0.261、0.215、0.116,P<0.05);高危因素数量与羊水过少、FGR、早产、剖宫产正相关(r=0.262、0.129、0.124、0.190,P<0.05)。478例新生儿的平均体重为(3135.7±469.5)g。无子痫患者的新生儿平均体重为(3156.60±442.53)g,高于子痫患者的(2660.00+756.44)g,差异具有统计学意义(P<0.05);高龄与非高龄、IVF与非IVF、GDM与非GDM患者的新生儿平均�Objective To analyze pregnancy outcomes in patients with hypothyroidism during pregnancy,and explore the correlation between high-risk factors and pregnancy outcomes.Methods Retrospective analysis was made on 478 cases of hypothyroidism during singleton pregnancy,including 82 cases(17.15%)of elderly patients(≥35 years old),91 cases(19.04%)of gestational diabetes mellitus(GDM),44 cases(9.21%)of in vitro fertilization(IVF),and 20 cases(4.18%)of eclampsia;oligohydramnios,neonatal hyperbilirubinemia,fetal distress,neonatal asphyxia,fetal growth restriction(FGR),premature delivery and cesarean section were 20 cases(4.18%),100 cases(20.92%),37 cases(7.74%),11 cases(2.30%),21 cases(4.39%),28 cases(5.86%)and 188 cases(39.33%),respectively.The clinical data and pregnancy outcomes of the patients were statistically sorted out,and the delivery modes of patients with different characteristics were compared;the correlation between high risk factors,and the correlation between high-risk factors and delivery outcome were analyzed;the neonatal weight of patients with different risk factors was compared.Results Patients who delivered by cesarean section were older than those who delivered by normal delivery,and the difference was statistically significant(P<0.05).The rate of cesarean section in patients with eclampsia was the highest,and the proportion of elderly and eclampsia in patients with cesarean section was higher than that in patients with spontaneous delivery,and the difference was statistically significant(P<0.05).The cesarean section rate of patients with different number of high-risk factors was statistically significant(P<0.05).The cesarean section rate increased with the increase of the number of highrisk factors.The proportion of GDM and IVF in cesarean section patients was not significantly different from that in normal delivery patients(P>0.05).In patients with hypothyroidism during pregnancy,advanced age was positivelycorrelated with GDM and eclampsia(r=0.147,0.099;P<0.05),and IVF was positively correlated wit

关 键 词：妊娠期甲状腺功能减退症 妊娠结局 高危因素 相关性 

分 类 号：R714.256[医药卫生—妇产科学]