摘要
目的探讨孕妇妊娠前半期（≤20周）血清甲状腺过氧化物酶抗体（TPOAb）阳性对母体甲状腺功能（甲功）和妊娠不良结局的影响。方法选取妊娠前半期孕妇352例,检测血清促甲状腺激素（TSH）、游离甲状腺素（FT4）、三碘甲状腺原氨酸（FT3）和TPOAb,记录各种妊娠不良结局,分析TPOAb阳性与甲功减退症（甲减）及妊娠不良结局的关系。结果妊娠前半期血清TPOAb阳性率为10.23%,妊娠8周亚临床甲减组TPOAb阳性率显著高于甲功正常组,TPOAb阳性组亚临床甲减发生率显著高于TPOAb阴性组（P=0.047、0.036）;妊娠前半期TPOAb阳性组胎盘早剥、流产、早产及总妊娠不良结局发生率均显著高于阴性组,差异有显著意义（OR=4.229-18.364,95%CI=1.231-208.006,P〈0.05）;甲功正常TPOAb阳性组胎儿窘迫、流产、早产、低体质量儿及总妊娠不良结局的发生率显著高于TPOAb阴性组,差异有显著性（OR=9.571-13.692,95%CI=1.298-70.600,P〈0.05）。结论妊娠前半期TPOAb阳性可能是妊娠期亚临床甲减和妊娠不良结局发生的高危因素。
Objective To investigate the effect of serum thyroid peroxidase antibody （TPOAb） positive -during the first half （420 weeks） o5 pregnancyon the maternal thyroid function and adverse pregnancy outcomes. Methods This study consisted of 352 pregnant women at the first half of pregnancy. Serum thyrotropin （TSH）, triiodothyronine （FT3）, free thyroxine （FT4） and thyroid peroxidase antibody （TPOAb） were detected, all kinds of adverse pregnancy outcomes were recorded, and the association of TPOAb positive with hypothyroidism and adverse pregnancy outcomes was analyzed. Results The positive rate of TPOAb was 10.23% at the first half of pregnancy. At eight weeks of pregnancy, in subclinical hypothyroidism group, the positive rate of TPOAb was significantly higher than that in normal thyroid function group （P =0.047）. In TPOAb-positive group, the in- cidence of subclinical hypothyroidism was higher than that in TPOAb-negative group （P =0.036）. At the first half of pregnancy, the incidence of placental abruption, abortion, premature delivery and total pregnancy adverse outcomes in TPOAb positive group was higher than that in TPOAb-negative group （OR=4.229-18.36,,95%CI=1.231-208.006,P〈0.05）. The incidence of fetal distress, abortion, premature delivery, low birth weight and total pregnancy adverse outcomes in TPOAb-positive group of normal thyroid function was higher than that in TPOAb-negative group （OR =9.571-13.692,95%CI=1.298-70.600,P〈0.05）. Conclusion At the first half of pregnancy, TPOAb positive may be the high risk factor of subclinical hypothyroidism during pregnancy and adverse pregnancy outcomes.
作者
吴晓雯
崔高飞
邢燕
赵文娟
申宝明
WU Xiaowen CUI Gaofei XING Yan ZHAO Wenjuan SHEN Baoming(Department of Endocrinology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Chin)
出处
《青岛大学医学院学报》
CAS
2016年第6期692-695,共4页
Acta Academiae Medicinae Qingdao Universitatis
