孕期甲状腺功能与新生儿早产的相关性研究  

The correlation between thyroid function during pregnancy and premature delivery

作　　者：郑洁燕 张庆英[1] ZHENG Jieyan;ZHANG Qingying(Department of Preventive Medicine,Shantou University Medical College,Shantou 515041,China;Department of Preventive Health,Jieyang People's Hospital,Jieyang 522081,China)

机构地区：[1]汕头大学医学院预防医学系,广东汕头515041 [2]揭阳市人民医院预防保健科,广东揭阳522081

出　　处：《汕头大学医学院学报》2024年第1期30-34,共5页Journal of Shantou University Medical College

摘　　要：目的:探讨不同孕期甲状腺功能与新生儿早产风险的相关性,为孕期甲状腺功能监测及预防不良新生儿结局提供依据。方法:选取2021年1月—2023年6月在揭阳市人民医院分娩的1248例产妇及其新生儿为研究对象,产妇年龄18~46(27.8±4.1)岁;新生儿,男675例,女573例,出生胎龄181~295(271.9±13.1)d,收集产妇的年龄、孕产史、妊娠期并发症、甲状腺功能指标(包括促甲状腺激素、游离甲状腺素)以及新生儿的出生胎龄、体重等临床资料。采用多因素logistic回归模型分析孕期甲状腺功能异常与新生儿早产发生风险的关系。结果:新生儿早产发生率为6.97%(87/1248)。多因素logistic回归分析结果显示,产妇促甲状腺激素水平异常(OR=1.981,95%CI:1.009~3.926)、游离甲状腺素水平异常(OR=2.823,95%CI:1.442~5.525)、低蛋白(OR=4.651,95%CI:2.190~9.878)、妊娠期高血压(OR=4.441,95%CI:2.314~8.525)、妊娠期糖尿病(OR=1.846,95%CI:1.002~3.541)可能是新生儿早产的相关因素(均P<0.05)。不同孕期的促甲状腺激素、游离甲状腺素水平及其异常率差异均有统计学意义(均P<0.05)。结论:孕期甲状腺功能异常可能与新生儿早产风险增高相关,孕中期促甲状腺激素和孕晚期游离甲状腺素水平的监测可能有助于预防新生儿早产的发生。Objective:To investigate the correlation between thyroid function during pregnancy and premature delivery,and to provide a basis for monitoring thyroid function during pregnancy and preventing adverse neonatal outcomes.Methods:1248 cases of pregnant women and their newborns who gave birth in Jieyang People’s Hospital from January 2021 to June 2023 were selected for the study.Pregnant women age ranged from 18 to 46(27.8±4.1)years old;newborns,675 males and 573 females,with gestational age at birth of 181-295(271.9±13.1)d.Clinical data such as maternal age,pregnancy and childbirth histories,complications during pregnancy,indicators of thyroid function(including thyroid stimulating hormone and free thyroxine),and newborns’birth gestational age and body weight were collected.A multivariate logistic regression model was employed to analyze the relationship between abnormal thyroid function during pregnancy and the risk of premature delivery.Results:The incidence of premature delivery was 6.97%(87/1248).The results of logistic regression analysis showed that abnormal maternal thyroid stimulating hormone levels(OR=1.981,95%CI:1.009-3.926),abnormal free thyroxine levels(OR=2.823,95%CI:1.442-5.525),low protein(OR=4.651,95%CI:2.190-9.878),gestational hypertension(OR=4.441,95%CI:2.314-8.525),gestational diabetes mellitus(OR=1.846,95%CI:1.002-3.541)may be the correlates of premature delivery(all P<0.05).The differences in thyroid stimulating hormone and free thyroxine levels and their abnormality rates between different trimesters were statistically significant(all P<0.05).Conclusion:Abnormal thyroid function during pregnancy may be correlated with an increased risk of neonatal premature delivery,and monitoring of thyroid stimulating hormone in the second trimester and free thyroxine levels in the third trimester may be helpful in preventing premature delivery.

关 键 词：妊娠期 促甲状腺激素 游离甲状腺素 早产 

分 类 号：R714.2[医药卫生—妇产科学]