妊娠合并亚临床甲状腺功能减退症的早期治疗对妊娠结局的影响

The Effect of Early Treatment on Pregnancy Outcome in Patients with Subclinical Hypothyroidism

目的:探讨妊娠合并亚临床甲状腺功能减退症(SCH)的早期治疗对妊娠结局的影响。方法:回顾性分析2012年11月至2013年8月在苏州大学附属第一医院围生期检查并住院分娩的148例SCH孕妇,其中经左甲状腺素钠早期治疗的86例(SCH治疗组),未经药物干预治疗的62例(SCH未治疗组),随机选取同期住院的甲状腺功能正常的孕妇120例(正常对照组),分析3组孕妇的妊娠结局。结果:SCH未治疗组产科并发症、不良妊娠结局的发生率高于SCH治疗组和正常对照组,剖宫产率高于SCH治疗组和正常对照组(P<0.05);SCH治疗组的产科并发症及不良妊娠结局和正常对照组差异无统计学意义(P>0.05)。结论:妊娠合并SCH对妊娠结局有不良影响,早期治疗可以有效降低产科并发症的发生率,改善妊娠结局。

Objective：To investigate the influence on pregnancy outcomes of early treatment for subclinical hypothyroidism （SCH）during pregnancy, Methods：The clinical data of 148 cases of pregnant women with SCH who had perinatal checks and delivered in the First Hospital Affiliated to Soochow University during November 2012 and August 2013 were retrospectively analyzed. These 148 cases were divided into two groups：intervention group （86 cases）and non-intervention group（62 cases）,according to accepting medical intervention or not. 120 randomly-selected women with normal thyroid function hospitalized in the same hospital during the same period were enrolled into the control group. The pregnancy outcomes of three groups of pregnant women were compared. Results ：The incidence of obstetrical complication and adverse pregnancy outcomes as well as cesarean delivery rate in non-intervention group were significantly higher than the control group（ P 〈0. 05） ;Meanwhile, there was no significant difference in the incidence of complication and adverse pregnancy outcomes between non-intervention group and the control group（ P 〉 0.05）. Conclusions： Subclinical hypothyroidism （SCH） during pregnancy has a negative influence on pregnancy, early diagnosis and treatment effectively decreases the complication incidence and improves the pregnancy outcome.