妊娠晚期亚临床甲状腺功能减退症危险因素分析  

Analysis of risk factors for subclinical hypothyroidism in late pregnancy

作　　者：王崇丹 杨燕峰 甘雨 任志缘 石竹青 祁西花 康晓敏 郭文星 姜云生[8] WANG Chongdan;YANG Yanfeng;GAN Yu;REN Zhiyuan;SHI Zhuqing;QI Xihua;KANG Xiaomin;GUO Wenxing;JIANG Yunsheng(Department of Obstetrics and Gynecology,Tianjin Binhai New Area Tanggu Obstetrics and Gynecology Hospital,Tianjin 300451,CHINA)

机构地区：[1]天津市滨海新区塘沽妇产医院妇产科,300451 [2]天津市滨海新区卫生健康委疾病预防控制室 [3]黄南藏族自治州人民医院产科,青海 [4]天津医科大学公共卫生学院营养与食品卫生学系 [5]河南蒙古族自治县人民医院妇产科,青海 [6]河南蒙古族自治县妇幼保健和计划生育服务中心妇产科,青海 [7]河南蒙古族自治县妇幼保健和计划生育服务中心院长办公室 [8]天津市第五中心医院内分泌科

出　　处：《江苏医药》2024年第11期1131-1134,1139,共5页Jiangsu Medical Journal

基　　金：天津市卫生健康委员会科技项目(RK20001);天津市环境营养与人群健康重点实验室开放课题(2020ENKL03);中国营养学会达能基金(DIC2022-04)。

摘　　要：目的 分析妊娠晚期亚临床甲状腺功能减退症(SCH)的危险因素。方法 分析黄南藏族自治州(黄南州)712例妊娠晚期孕妇的临床资料。其中,患有SCH孕妇116例(病例组),甲状腺功能正常孕妇596例(对照组)。比较两组临床和实验室指标。采用多因素logistic回归分析妊娠晚期孕妇SCH的独立危险因素。结果 与对照组相比,病例组孕妇妊娠晚期收缩压和TSH水平较高,FT4水平和新生儿体重较低,藏族、妊娠期贫血、妊娠期高血压、小于孕龄儿和出生男婴比例较高(P<0.05)。多因素logistic回归分析结果显示,有妊娠期高血压、小于孕龄儿及男婴是妊娠晚期孕妇SCH的独立危险因素(P<0.05)。结论 在医疗资源缺乏、经济实力不足的黄南州,对于患妊娠期高血压、小于孕龄儿和孕育男婴的高风险孕妇应尽早进行甲状腺功能筛查,以降低母婴不良妊娠结局的发生。Objective To analyze the risk factors for subclinical hypothyroidism(SCH)in late pregnancy.Methods The clinical data of 712 pregnant women in late pregnancy living in Huangnan Tibetan Autonomous Prefecture were analyzed,of whom 116 cases were with SCH(group A)and 596 cases were with normal thyroid function(group B).The clinical and laboratory indicators were compared between the two groups.Multivariate logistic regression was used to analyze the risk factors for SCH in late pregnancy.Results Compared with group B,the levels of systolic blood pressure and TSH in late pregnancy were higher,the levels of FT4 and newborn weight were lower,and the proportions of Tibetan,gestational anemia,gestational hypertension,small for gestational age and male infants were higher in group A(P<0.05).The results of multivariate logistic regression analysis showed that gestational hypertension,small for gestational age and male infants were the independent risk factors for SCH in late pregnancy(P<0.05).Conclusion In Huangnan Tibetan Autonomous Prefecture with limited medical resources and poor economic power,thyroid function screening should be performed as early as possible in high-risk pregnant women with gestational hypertension,small for gestational age and male infants to reduce the occurrence of adverse maternal and infant pregnancy outcomes.

关 键 词：亚临床甲状腺功能减退症 妊娠 

分 类 号：R714[医药卫生—妇产科学]