摘要
目的分析亚临床甲状腺功能减退(SCH)与妊娠结局的关系。方法采用巢式病例对照的研究方法,选取2021年8月-2022年2月在甘肃省妇幼保健院门诊产检并建档的124例SCH患者为SCH组,选取232例同期就诊的甲状腺功能正常的孕妇作为对照组,以问卷调查的方式获取研究对象一般情况、本次怀孕情况、妊娠相关病史,通过医院病案系统查询研究对象的妊娠结局。比较两组母血血清促甲状腺激素(TSH)、游离T4(FT4)、血红蛋白(Hb)、总蛋白(TP)、白蛋白(ALB)、球蛋白(GLO)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,分析妊娠期SCH与妊娠结局的关系。结果SCH组孕中期[3.33(2.28,4.71)m IU/L vs.1.92(1.42,2.39)mIU/L]、晚期[3.33(2.28,4.72)mIU/L vs.1.80(1.23,2.50)mIU/L]TSH水平均高于对照组(Z=-8.834、-8.607,P均<0.001),孕中期[12.50(11.10,14.20)mmol/L vs.16.20(13.80,17.65)mmol/L]、孕晚期[13.00(11.60,15.20)mmol/L vs.16.88(15.18,18.00)mmol/L]FT4水平低于对照组(Z=-7.568、-7.729,P均<0.001),差异均有统计学意义。两组TP低水平、TC高水平、LDL-C低水平,妊娠糖尿病、妊娠高血压、胎膜早破、贫血发生率差异均有统计学意义(χ^(2)=7.981、5.011、24.820、9.959、5.526、5.092、9.486,P均<0.05)。SCH组新生儿早产(36.29%vs.17.67%)、房间隔缺损(23.39%vs.12.93%)发生率高于对照组,差异均有统计学意义(χ^(2)=15.288、6.390,P均<0.05)。结论妊娠期SCH会引发妊娠合并症、不良妊娠结局,影响母婴健康。
Objective To analyze the relationship between subclinical hypothyroidism(SCH)and pregnancy outcome.Methods A nested case-control study was conducted.A total of 124 subclinical hypothyroidism patients in Gansu Maternal and Child Health Hospital from August 2021 to February 2022 were selected as the SCH group,and 232 pregnant women with normal thyroid function who were treated in our hospital at the same time were selected as the control group.The general situation,current pregnancy situation and pregnancy-related medical history of the study subjects were obtained by questionnaire survey.The pregnancy outcome of the study subjects was searched through the hospital medical record system.The levels of thyroid stimulating hormone(TSH),free thyroxine(FT4),hemoglobin(Hb),total protein(TP),albumin(ALB),globulin(GLO),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C)in maternal blood of the two groups were compared to explore the relationship between SCH during pregnancy and pregnancy outcome.Results The TSH levels in the SCH group were higher than those in the control group in the second trimester[3.33(2.28,4.71)mIU/L vs.1.92(1.42,2.39)mIU/L]and late pregnancy[3.33(2.28,4.72)mIU/L vs.1.80(1.23,2.50)mIU/L](Z=-8.834,-8.607;all P<0.001).The FT4 levels in the second trimester[12.50(11.10,14.20)vs.16.20(13.80,17.65)]and the third trimester[13.00(11.60,15.20)mmol/L vs.16.88(15.18,18.00)mmol/L]were significantly lower than those in the control group(Z=-7.568,-7.729;all P<0.001).There were statistically significant differences in the incidence rates of low TP levels,high TC levels,low LDL-C levels,gestational diabetes,gestational hypertension,and premature rupture of membranes between the two groups(χ^(2)=7.981,5.011,24.820,9.959,5.526,5.092,9.486;all P<0.05).The incidence rates of neonatal premature birth(36.29%vs.17.67%)and atrial septal defect(23.39%vs.12.93%)in the SCH group were significantly higher than those in the control group(χ^(2)=15.288,6.390;all P<0.05).Conclusion Pregnancy SCH could lead to pregnancy complications and adverse pregnancy outcomes,affecting maternal and child health.
作者
焦新娟
孙健豪
唐娇
郝胜菊
王兴鑫
李国茹
何静
王艳波
JIAO Xinjuan;SUN Jianhao;TANG Jiao;HAO Shengju;WANG Xingxin;LI Guoru;HE Jing;WANG Yanbo(School of Nursing,Gansu University of Traditional Chinese Medicine,Lanzhou,Gansu 730000,China;不详)
出处
《热带医学杂志》
CAS
2023年第10期1423-1427,共5页
Journal of Tropical Medicine
基金
国家自然科学基金(12005042)
甘肃省出生缺陷与罕见病临床医学研究中心(21JR7RA680)
