甲状腺激素治疗妊娠期亚临床甲减对子代生长发育的影响  

Effects of thyroid hormone for treating pregnant women with subclinical hypothyroidism on the growth and development of offspring of the women

作　　者：郝士丹 许颖[2] 张景义[2] HAO Shidan;XU Ying;ZHANG Jingyi(Tang Shan Hongci Hospital,Tangshan,Hebei Province,063000;Kailuan Hospital,Tangshan,Hebei Province)

机构地区：[1]河北省唐山弘慈医院,063000 [2]开滦总医院

出　　处：《中国计划生育学杂志》2023年第5期1067-1071,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨甲状腺激素治疗妊娠期亚临床甲状腺功能减退(SCH)对妊娠结局及子代生长发育的影响。方法:选取2019年3月-2020年3月本院妇产科接诊的240例孕妇,根据甲状腺功能筛查结果分为正常组(175例)和SCH组(65例),SCH患者均接受左甲状腺素(LT4)治疗。观察孕妇妊娠期甲状腺功能指标变化、妊娠结局,比较2组子代0~24月龄的体格发育及神经智力发育情况。结果:两组初诊孕周、孕26周及孕36周的游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)水平均无差异(P>0.05)。与初诊孕周相比,SCH组孕26周、孕36周的血清促甲状腺激素(TSH)及甲状腺过氧化物酶抗体(TPO-Ab)水平均降低(P<0.05),但SCH组初诊孕周、孕26周及孕36周的TSH及TPO-Ab水平均高于正常组(P<0.05);不良妊娠结局总发生率SCH组(4.6%)与正常组(4.0%)无差异(P>0.05)。两组胎儿的双顶径及子代各时期(出生时、1月龄、6月龄、12月龄)的身高、体重比较,差异均无统计学意义(P>0.05)。两组孕妇子代24月龄的大运动、精细动作、适应能力、语言、社会行为发育商及发育商异常率比较均无差异(P>0.05)。结论:对妊娠期SCH患者早期进行甲状腺激素治疗有助于预防不良妊娠结局发生,利于子代体格及神经智力发育,子代短期的体格及神经智力发育水平与甲状腺功能正常孕妇子代相当。Objective:To investigate the effects of thyroid hormone for treating pregnant women with subclinical hypot-hyroidism(SCH)on the growth and development of offspring of the women.Methods:240 pregnant women were se-lected and were divided into control group(175 normal pregnant women)and study group(65 pregnant women with SCH)according to the results of their thyroid function screening.The women in the study groups received the treat-ment of levothyroxine(LT4).The changes of thyroid function indexes and the pregnancy outcomes of the women in the two groups were observed.The physical and mental development of the offspring aged 0-24 months of the women were compared between the two groups.Results:There were no significant differences in the levels of free thyroxine(FT4)and free triiodothyronine(F T3)of the women during the gestational week at the first visiting the doctor,or during the 26th or 36th gestational week between the two groups(P>0.05).The levels of serum thyroid stimulating hormone(TSH)and thyroid peroxidase antibody(TPO-Ab)of the women in the study group during the 26th or 36th gestational week were significantly lower than those of the women during the gestational week at the first visiting the doctor(P<0.05).The levels of TSH and TPO-Ab of the women in the study group during the gestational week at the first visiting the doctor,or during the 26th or 36th gestational week were significantly higher than those of the women in the control group(P<0.05).There was no significant difference in the total incidence of the adverse pregnancy outcomes(4.6%vs.4.0%)of the women between the two groups(P>0.05).There were no significant differences in the double parietal diameter of the fetus,the height and weight of the offspring at birth,age of 1 month old,age of 6 months,and age of 12 months,and the developmental quotient and the abnormal rate of the developmental quotient of the grand motor,fine motor,adaptive ability,language,and social behavior of the offspring age of 24 month between the two groups(P>0.05).Conclus

关 键 词：妊娠期亚临床甲状腺功能减退 甲状腺激素治疗 子代 体格发育 神经智力发育 

分 类 号：R714.256[医药卫生—妇产科学]