摘要
目的探讨亚临床甲状腺功能减退(亚临床甲减)对乌鲁木齐地区孕妇妊娠结局的影响,并观察左旋甲状腺素片干预后妊娠结局的变化。方法回顾性分析2016年1月至2017年4月在乌鲁木齐市妇幼保健院产检的健康孕妇6 384例的临床资料,其中甲状腺功能正常孕妇6 019例(A组),亚临床甲减孕妇365例,再根据是否使用左旋甲状腺素片干预将365例亚临床甲减孕妇分为亚临床甲减对照组(B组,183例)和左旋甲状腺素片干预观察组(C组,182例)。比较3组的妊娠结局和新生儿情况。结果 3组间妊娠期高血压疾病、羊水异常发生率无显著性差异(P>0.05)。妊娠期糖尿病、早产、剖宫产、产后出血、胎盘早剥在A组的发生率为2.13%、7.24%、21.02%、3.59%、1.23%,在C组为3.30%、8.24%、23.63%、4.40%、1.65%,A、C组间上述指标比较差异无统计学意义(P>0.05),但均低于B组的9.29%、13.11%、38.80%、8.74%、3.83%(P<0.05)。3组间低体重儿、巨大儿发生率比较,差异无统计学意义(P>0.05)。胎儿宫内窘迫、Apgar评分0~3分、Apgar评分4~7分的比率A组为3.12%、0.45%、1.28%,C组为3.84%、0.55%、1.65%,A、C组间上述指标比较差异无统计学意义(P>0.05),但均低于B组的6.01%、3.28%、4.92%(P<0.05)。结论妊娠期亚临床甲减会对孕产妇和胎儿带来危害,积极的干预可以显著降低不良妊娠结局的发生率。
Objective To explore the effect of subclinical hypothyroidism on pregnancy and the intervention of thyroxine.Methods The clinical data of 6 384 cases of healthy pregnant women from January 2016 to April 2017 in Urumqi Maternal and Child Health Care Hospital were retrospectively analyzed.Among them,6 019 pregnant women were with normal thyroid function（ group A）and 365 pregnant women were with subclinical hypothyroidism.According to whether used levothyroxine tablets,365 cases of subclinical hypothyroidism were divided into subclinical hypothyroidism control group（ group B,183 cases） and levothyroxine tablets intervention group（ group C,182 cases）.The pregnancy outcomes and neonatal conditions were compared between the three groups.Results There was no significant difference of the incidence of hypertensive disorder complicating pregnancy and amniotic fluid abnormalities between group A,group B and group C（ P 0.05）.The incidence of gestational diabetes,premature birth,cesarean section,postpartum hemorrhage and placental abruption in group A were 2.13 %,7.24 %,21.02 %,3.59 % and 1.23 %,and3.30 %,8.24 %,23.63 %,4.40 % and 1.65 % in group C,respectively.Which were all lower than that of 9.29 %,13.11 %,38.80 %,8.74 % and 3.83 % in group B（ P 0.05）.There was no significant difference of the incidence of low birth weight infants and macrosomia between the 3 groups（ P 0.05）.The rates of fetal distress,Apgar 0 ~ 3 score and Apgar 4 ~ 7 score in group A were3.12 %,0.45 % and 1.28 %,and 3.84 %,0.55 %,and 1.65 % in group C,respectively.Which were all lower than that of6.01 %,3.28 %,and 4.92 % in group B（ P 0.05）.Conclusion Subclinical hypothyroidism in pregnancy can be harmful to pregnant women and fetuses.Active intervention can significantly reduce the incidence of adverse pregnancy outcomes.
作者
冯乐
李妍
秦敏春
FENG Le;Li Yan;QIN Min-chun(Department of Clinical Laboratory,Urumqi Maternal and Child Health Care Hospital,Urumqi Xinjiang 830000,P.R.China)
出处
《中国计划生育和妇产科》
2018年第8期79-81,共3页
Chinese Journal of Family Planning & Gynecotokology
