孕早期单纯低甲状腺素血症的影响因素和对妊娠结局的影响  

Influencing factors of isolated hypothyroxinemia in early pregnancy and its effect on pregnancy outcomes

作　　者：刘冬 许雅娟[1] 李晶晶 田鑫 胡琳 孙宗宗 张晨晨 林鹏鲲 王怡鑫 LIU Dong;XU Yajuan;LI Jingjing;TIAN Xin;HU Lin;SUN Zongzong;ZHANG Chenchen;LIN Pengkun;WANG Yixin(Department of Obstetrics,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第三附属医院产科,河南郑州450052

出　　处：《中国医学工程》2025年第3期62-67,共6页China Medical Engineering

摘　　要：目的 探讨孕早期单纯低甲状腺素血症(IH)的影响因素及对妊娠结局的影响。方法 回顾性分析2021年9月至2024年2月在郑州大学第三附属医院分娩的孕早期IH孕妇117例(IH组),选取同期甲状腺功能正常孕妇117例为对照组。采用二元Logistic回归分析探究IH的影响因素,Spearman相关分析探讨FT4水平与相关指标的相关性,比较两组孕妇的妊娠结局。结果 IH组的血清铁蛋白、血红蛋白(Hb)、铁元素、高密度脂蛋白(HDL)水平低于对照组,年龄、甘油三酯(TG)水平、铁缺乏和贫血的发生率高于对照组(P<0.05)。二元Logistic回归分析结果显示,年龄增加(OR=1.109,95%CI=1.034~1.190,P=0.004)、铁缺乏(OR=6.720,95%CI=2.488~18.153,P<0.001)、贫血(OR=9.806,95%CI=2.863~33.586,P<0.001)、TG升高(OR=2.116,95%CI=1.498~2.988,P<0.001)是IH的危险因素,铁蛋白升高(OR=0.975,95%CI=0.965~0.985,P<0.001)、Hb升高(OR=0.889,95%CI=0.858~0.922,P<0.001)、HDL升高(OR=0.392,95%CI=0.186~0.828,P=0.014)是IH的保护因素。FT4与TG (rs=-0.375,P<0.001)、新生儿出生体重(rs=-0.233,P<0.001)、身长(rs=-0.157,P=0.019)呈负相关,与铁蛋白(rs=0.373,P<0.001)、Hb (rs=0.459,P<0.001)、HDL (rs=0.164,P=0.012)呈正相关。IH组妊娠期糖尿病(GDM)和巨大儿的发生率、新生儿出生体重和身长高于对照组(P<0.05),控制混杂因素后,IH仅与GDM有关(OR=2.112,95%CI=1.006~4.434,P=0.048)。结论 年龄、铁蛋白、Hb、铁缺乏、贫血、TG、HDL是孕早期IH的影响因素。孕早期IH增加GDM的发生风险,影响新生儿的生长发育。【Objective】To investigate the influencing factors and pregnancy outcomes of isolated hypothyroinemia(IH)in early pregnancy.【Methods】A total of 117 pregnant women with IH(IH group)who gave birth in the Third Affiliated Hospital of Zhengzhou University from September 2021 to February 2024 were retrospectively analyzed,and 117 pregnant women with normal thyroid function were selected as the control group.Binary logistic regression analysis was used to explore the influencing factors of IH.Spearman rank correlation analysis was used to investigate the correlation between FT4 level and related indicators.The pregnancy outcomes between the two groups were compareed.【Results】The levels of serum ferritin,hemoglobin(Hb),iron and high density lipoprotein(HDL)in IH group were lower than those in control group,and age,serum triglyceride(TG)level,the incidence of iron deficiency and anemia in IH group were higher than those in control group(P<0.05).Binary logistic regression analysis showed that age(O^R=1.109,95%CI:1.034–1.190,P=0.004),iron deficiency(O^R=6.720,95%CI:2.488–18.153,P<0.001),anemia(O^R=9.806,95%CI:2.863–33.586,P<0.001),TG increased(O^R=2.116,95%CI:1.498–2.988,P<0.001)were risk factors for IH,and ferritin increased(O^R=0.975,95%CI:0.965–0.985,P<0.001),Hb increased(O^R=0.889,95%CI:0.858–0.922,P<0.001),HDL increased(O^R=0.392,95%CI:0.186–0.828,P=0.014)were protective factors for IH.FT4 was negatively correlated with TG(rs=-0.375,P<0.001),birth weight(rs=-0.233,P<0.001),length(rs=-0.157,P=0.019),and positively correlated with ferritin(rs=0.373,P<0.001),Hb(rs=0.459,P<0.001),HDL(rs=0.164,P=0.012).The incidence of gestational diabetes mellitus(GDM)and macrosomia,neonatal birth weight and length in IH group were higher than in the control group(P<0.05),and after controlling for confounding factors,IH was only associated with GDM(O^R=2.112,95%CI:1.006–4.434,P=0.048).【Conclusion】Age,ferritin,Hb,iron deficiency,anemia,TG and HDL are the influencing factors of IH in early pregnancy.IH in earl

关 键 词：单纯低甲状腺素血症 孕早期 影响因素 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]