摘要
目的:探讨孕早中晚期甲状腺功能减退(甲减)孕妇血清甲状腺激素水平与低出生体重儿的相关性。方法:选择150例甲减孕妇作为观察组,另选150例同期规律产检正常的孕妇作为对照组,两组孕早期、孕中期和孕晚期均各50例;检测两组血清甲状腺激素水平,包括游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH);使用Pearson相关性分析血清甲状腺激素水平与新生儿出生体重的关系,受试者工作特征(ROC)曲线分析血清甲状腺激素水平对低出生体重儿的预测效能。结果:对照组不同孕期FT3、FT4和TSH水平比较无统计学差异(均P>0.05);观察组孕早期、孕中期及孕晚期FT3水平低于对照组,TSH水平高于对照组(均P<0.05);经Pearson相关性分析,甲减孕妇孕早期、孕中期及孕晚期FT3水平与新生儿出生体重呈正相关(均P<0.05),TSH水平与新生儿出生体重呈负相关(P<0.05);经多因素Logistic回归分析,孕中期FT3和TSH均是甲减孕妇发生低出生体重儿的独立预测因素(P<0.05);经ROC曲线分析,孕中期FT3联合TSH预测甲减孕妇发生低出生体重儿的ROC曲线下面积(AUC)为0.900。结论:孕早中晚期甲减孕妇血清FT3和TSH均与新生儿出生体重密切相关,孕中期FT3联合TSH预测低出生体重儿的效能较好。
Objective:To analyze the correlation between serum thyroid hormone levels and low birth weight infants in pregnant women with hypothyroidism in the first,second and third trimester.Methods:A total of 150 pregnant women with hypothyroidism were selected as the observation group,and 150 pregnant women with normal pregnancy during the same period were selected as the control group,50 cases in the first trimester,50 cases in the second trimester and 50 cases in the third trimester.Serum thyroid hormone levels,including free triiodothyronine(FT3),free thyroxine(FT4)and thyroid stimulating hormone(TSH),were detected in the two groups.Pearson correlation was used to analyze the relationship between serum thyroid hormone levels and neonatal birth weight.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of serum thyroid hormone levels in low birth weight infants.Results:There were no significant differences in the levels of FT3,FT4 and TSH in the control group during different pregnancies(all P>0.05).The levels of FT3 in the first,second and third trimester in the observation group were lower than those in the control group,and the levels of TSH were higher than those in the control group(all P<0.05).Pearson correlation analysis showed that FT3 levels in the first,second and third trimesters were positively correlated with neonatal birth weight,and TSH levels were negatively correlated with neonatal birth weight(all P<0.05).Multivariate Logistic regression analysis showed that both FT3 and TSH in the second trimester were independent predictors of low birth weight(all P>0.05).According to the ROC curve analysis,the area under the ROC curve(AUC)of FT3 combined with TSH in the second trimester in predicting low birth weight infants was 0.900.Conclusion:The serum FT3 and TSH of pregnant women with hypothyroidism in the first,second and third trimester are closely related to neonatal birth weight,the combination of FT3 and TSH in the second trimester is effective in predicting low birth weight infants.
作者
屈勇
李晶
QU Yong;LI Jing(Department of Endocrinology,XD Group Hospital,Xi’an 710077,China)
出处
《陕西医学杂志》
CAS
2023年第5期604-607,共4页
Shaanxi Medical Journal
基金
高端外国专家引进计划项目(G2022041016L)。
