亚临床甲状腺功能减退对妊娠期孕妇焦虑、抑郁情绪及新生儿的影响

Effects of subclinical hypothyroidism on anxiety,depression and neonatal outcomes in pregnant women

目的研究亚临床型甲状腺功能减退症(SHT)对妊娠期孕妇焦虑、抑郁情绪的影响,以及左甲状腺素钠片对新生儿的影响。方法选择2014年1月~2017年1月我院收治的150例患有SHT的孕妇作为研究组,并将其随机分成A组和B组(每组各75例),其中A组采用左甲状腺素钠片进行治疗,B组经患者及家属同意,未给予药物治疗,只是定期监测甲状腺功能情况,观察A、B两组孕妇妊娠期并发症、妊娠结局及新生儿情况。同时选择年龄、性别与研究组匹配的同期健康孕妇80例作为对照组,比较研究组和对照组汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分情况。结果研究组HAMA评分(15.13±3.22)和HAMD评分(22.06±2.71)分均明显高于对照组(7.68±1.04和8.93±1.65)。A组妊娠期并发症发生率和宫产率(20.0%,39.2%)明显低于B组妊(34.7%,47.8%)(P<0.05)。A组早产率及流产率均低于B组(P﹤0.05);A组新生儿出生体重(3.18±0.94 Kg)明显高于B组(2.67±0.71 Kg)。结论 SHT可能造成妊娠期孕妇出现焦虑、抑郁情绪,给SHT孕妇左甲状腺素钠片,可以有效降低不良妊娠结局的发生,减少妊娠期并发症的发生,提高新生儿出生体重。

Objective To investigate the influence of subclinical hypothyroidism（SHT）on pregnancy and the effect of Levothyroxine Sodium on the outcome of neonates.Methods 150 cases of pregnant women with SHT in our hospital were selected as the study group,and were randomly divided into A group and B group（n = 75）,patients in group A were treated by Levothyroxine Sodium Tablets,while patients in B group only regular monitored the thyroid function.The pregnancy complications,pregnancy outcome and neonatal situation in A and B groups were compared.At the same time,80 cases of healthy pregnant women were selected as control group,the scores of Hamilton Depression Scale（HAMD）and Hamilton Anxiety Scale（HAMA）in control group and study group were compared.Results The scores of HAMA（15.13±3.22）and HAMD（22.06±2.71）in study group were significantly higher than those in the control group（7.68±1.04 and 8.93±1.65）.The complication rate（20%）and cesarean section rate（39.2%）in the observation group were lower than those of the control group（34.7% and 47.8%）.The observation group premature birth rate and abortion rate were lower than the control group（P〈0.05）;neonatal birth weight in the observation group（3.18＋0.94 Kg）was significantly higher than that in the control group（2.67＋0.71 Kg）.Conclusion SHT may be induce anxiety and depressive in pregnant women.The Levothyroxine Sodium can effectively reduce the incidence of adverse pregnancy outcomes and the incidence of pregnancy complications in SHT pregnant women,and improve neonatal birth weight.