舟山海岛地区358名孕妇甲状腺激素影响因素调查研究

Influencing factors of thyroid hormones among pregnant women in Zhoushan

目的探讨舟山地区妊娠妇女的孕期各阶段甲状腺激素的影响因素。方法选取孕妇358名,检测其孕早期、孕中期、孕晚期血清甲状腺激素,并对其进行问卷调查,用logistic回归模型分析甲状腺素异常的影响因素。结果早、中、晚孕阶段分别发现甲状腺异常孕妇116、104、81例。早孕阶段孕妇甲状腺素异常的危险因素分别是孕前吸烟（OR=11.212,95%CI：5.965~19.232））、孕前饮酒（OR=2.151,95%CI：1.132~5.131）、孕前丈夫吸烟（OR=3.555,95%CI：2.216~6.325）、孕期中丈夫吸烟（OR=4.151,95%CI：1.350~8.254）、中度抑郁（OR=3.588,95%CI：1.059~7.233）、中度焦虑（OR=4.566,95%CI：2.128~8.612）（P〈0.05）;中孕阶段孕妇甲状腺素异常的危险因素分别是孕前吸烟（OR=4.123,95%CI：3.313~5.489）、孕前丈夫吸烟（OR=3.512,95%CI：1.247~6.220）、轻度焦虑（OR=5.335,95%CI：3.254~9.363）、中度焦虑（OR=7.151,95%CI：4.259~12.362）（P〈0.05）;晚孕阶段孕妇甲状腺素异常的危险因素分别是孕前吸烟（OR=2.251,95%CI：1.741~3.369）、轻度抑郁（OR=4.251,95%CI：2.699~7.984）、中度抑郁（OR=5.714,95%CI：2.364~10.284）、轻度焦虑（OR=7.596,95%CI：2.636~13.585）、中度焦虑（OR=5.151,95%CI：1.154~9.541）（P〈0.05）。结论孕妇和丈夫戒烟、缓解抑郁和焦虑的情绪,有助于防范和减少舟山本地区孕妇妊娠期甲状腺疾病。

Objective To discuss the influencing factors of thyroid hormones among pregnant women in Zhoushan. Methods 358 pregnant women were randomly enrolled into the study.A questionnaire survey was conducted and blood samples were collected to test the serum thyroid hormone levels during three stages of pregnancy.The influencing factors were analyzd by binary logistic regression model. Results Thyroid hormone abnormalities were found in 116,104 and 81women during the first,second and third trimester stage of pregnancy.The risk factors associated with the abnormality of thyroid hormone were pre-pregnancy smoking（OR=11.212,95%CI：5.965-19.232）,drinking（OR=2.151,95%CI：1.132-5.131）,husband smoking before and during their pregnancy（OR =3.555,95%CI：2.216-6.325,OR =4.151,95%CI：1.350-8.254）,moderate depression（OR=3.588,95%CI：1.059-7.233）,and moderate anxiety（OR=4.566,95%CI：2.128-8.612）（P〈0.05）during the first stage,and were pre-pregnancy smoking（OR=4.123,95%CI：3.313-5.489）,husband smoking before their pregnancy（OR=3.512,95%CI：1.247-6.220）,mild anxiety（OR=5.335,95%CI：3.254-9.363）,as well as moderate anxiety（OR=7.151,95%CI：4.259-12.362）（P〈0.05）during the second trimester,and were pre-pregnancy smoking（OR=2.251,95%CI：1.741-3.369）,mild depression（OR=4.251,95%CI：2.699-7.984）,moderate depression（OR=5.714,95%CI：2.364-10.284）,mild anxiety（OR=7.596,95%CI：2.636-13.585）,and moderate anxiety（OR=5.151,95%CI：1.154-9.541）（P〈0.05）during the third trimester of pregnancy. Conclusions Quitting smoking and trying to relief from depression and anxiety are better ways to prevent the abnormality of thyroid hormones among women during pregnancy.