孕妇血TPOAb异常对妊娠结局的影响

Effects of thyroid peroxidase antibody positive of pregnant women on pregnancy outcomes

目的通过对孕妇甲状腺过氧化物酶抗体(TPOAb)的测定,分析其阳性对孕早期甲状腺功能正常的孕妇妊娠结局的影响。方法以甲状腺功能正常的孕早期妇女为研究对象,比较TPOAb阳性和阴性组孕妇在妊娠过程中促甲状腺激素(TSH)水平,孕妇产科并发症的发生率和产后新生儿临床特征及TSH指标。结果在226例孕早期妇女中,TPOAb阳性和阴性组TSH水平差异有统计学意义(P<0.05);2组产科并发症的发生差异有统计学意义(P<0.05);新生儿身高、体重及Apagar评分等临床特征差异无统计学意义(P>0.05);但TPOAb阳性组产妇的新生儿TSH水平高于阴性组产妇的新生儿TSH水平,差异有统计学意义(P<0.05);相关分析显示,孕妇TPOAb滴度和TSH水平分别与新生儿TSH水平呈正相关(P<0.01)。结论 TPOAb阳性孕妇甲状腺功能有向亚临床甲状腺功能减退发展的趋势;孕早期妇女TPOAb阳性预示对其妊娠结局会有不利影响,孕妇TPOAb阳性可能会对新生儿甲状腺功能造成一定影响。

Objective To detect thyroid peroxidase antibody on pregnancy and to explore effects of outcomes of euthyroid early pregnant women,and to analyze the mechanism of screening and monitoring.Methods In this study,TPOAb positive and negative euthyroid in early pregnant women were selected as subjects,then the thyroid stimulating hormone(TSH) changes during pregnancy in the two groups were compared;the incidence of maternity complications,and neonatal clinical characteristics in newborns between two groups and TSH were also compared.Results 226 cases euthyroid pregnant women were enrolled in this study.The TSH complications were significantly different(χ2=11.936,P<0.05) between TPOAb positive and negative group;There was significant differences in maternity complications between the two groups(χ2=5.891,P<0.05),however,neonatal clinical characteristics in new born babies showed no significant differences(P>0.05).TSH levels in TPOAb positive group was higher than that of TPOAb negative group maternal newborn(t=4.386,P<0.05);Correlation analysis showed TPOAb and TSH level of pregnant women and newborn TSH levels were positively correlated(r=0.203,0.207,P<0.01for both).Conclusion TPOAb positive pregnant women have the trend to subclinical hypothyroidism;TPOAb positive in early pregnant women can predict pregnancy outcome;Pregnant women with TPOAb positive may cause certain effect on thyroid function of neonates.