妊娠合并亚临床甲状腺功能减退的危险因素及其对母婴结局的影响

Risk Factors for Pregnancy with Subclinical Hypothyroidism and Its Effect on Maternal-infant outcomes

【目的】探讨妊娠合并亚临床甲状腺功能减退(SCH)的危险因素及其对母婴结局的影响。【方法】选择2017年1月至2018年5月在江苏大学附属医院产科住院分娩的妊娠合并SCH的孕妇200例(观察组);另外选择同期收治的非SCH孕妇200例为对照组。观察两组孕妇并发症发生情况及母婴结局;并采用单因素和多因素Logistic回归分析妊娠合并SCH的影响因素。【结果】观察组孕妇妊娠期糖尿病(GDM)、贫血、胎膜早破发生率显著高于对照组(P<0.05);流产、早产、死胎等不良母婴结局发生率显著高于对照组(P<0.05)。单因素分析显示:年龄、孕前体质量指数(BMI)、文化程度、孕产史、自然流产史、吸烟或暴露于吸烟环境与妊娠合并SCH有关(P<0.05);多因素Logistic回归分析显示:年龄≥30岁、初产妇、孕前BMI<18 kg/m2是影响妊娠合并SCH的危险因素(P<0.05)。【结论】妊娠合并SCH可引发各类并发症;导致各种不良事件;严重影响母婴安全;临床上对本病应早筛查、早干预。

【Objective】 To explore the risk factors for pregnancy with subclinical hypothyroidism (SCH) and its influence on maternal-infant outcome.【Methods】 A total of 200 pregnant women with SCH receiving prenatal examination in the hospital from January 2017 to May 2018 were selected as the research group and 200 cases of non SCH were selected as the control group. The incidence rates of complications and pregnancy outcomes in these groups were observed. Univariate logistic regression analysis and multivariate logistic regression analysis were used to analyze age, pre-pregnancy body mass index(BMI) and educational level as well as the risk factors of pregnancy complicated with SCH. 【Results】 The incidence rates of gestational diabetes mellitus,anemia,and premature rupture of fetal membranes in the research group were significantly higher than those in the control group(P<0.05).The incidence rates of abortion, preterm birth, stillbirth in the research group were significantly higher than those in the control group(P<0.05).Univariate logistic regression analysis showed that age, pre-pregnancy BMI, education level, history of gestation, history of spontaneous abortion and smoking or exposure to smoking environment were correlated with pregnancy complicated with SCH (P<0.05).Multivariate logistic regression analysis showed that age-≥30 years, primiparity, pre-pregnancy BMI<18kg/m2 were risk factors of pregnancy complicated with SCH (P<0.05). 【Conclusion】 Pregnancy combined with subclinical hypothyroidism can lead to various complications, resulting in various adverse events, which seriously affects the safety of mother and child. In clinical, early detection and intervention should be made.