甲状腺功能对母婴结局的影响

Study of Effect of Thyroid Function on Maternal and Infant Outcomes of Pregnancy

目的探讨甲状腺功能对母婴结局的影响。方法选取2010年1月至2014年12月于延安市中医医院行产前检查的3152例孕妇为研究对象,在孕期进行甲状腺功能的检测,结果异常者给予适当治疗和监测,记录其母婴结局。结果 3152例孕妇中妊娠期间甲状腺功能正常者2642例(83.8%)、甲状腺功能亢进(甲亢)58例(1.8%)、甲状腺功能减退(甲减)40例(1.3%)、亚临床甲亢46例(1.5%)、亚临床甲减(SCH)208例(6.6%)、单纯低甲状腺激素血症158例(5.0%)。甲亢组的妊娠性糖尿病(GDM)、妊娠期高血压综合征(PIH)的发病率、甲减组的巨大儿的发病率、亚临床甲亢组的GDM的发病率、SCH组的早产的发病率分别为27.6%(16/58)、8.6%(5/58)、10.0%(4/40)、34.8%(16/46)、13.5%(28/208),显著高于甲状腺功能正常组的16.1%(425/2642)、2.8%(75/2642)、2.5%(60/2642)、16.1%(425/2642)、7.7%(202/2642),差异有统计学意义(P<0.05)。结论孕妇甲状腺功能状况与母婴结局有关,不同类型的甲状腺疾病可增加GDM、PIH、早产、巨大儿等的发生风险,故应积极监测孕妇的甲状腺功能状况,并给予适当治疗。

Objective To explore the effect of thyroid function on maternal and infant outcomes of preg- nancy. Methods Total of 3152 pregnant women who took antenatal care in Yan＇an City Chinese Medicine Hospital from Jan. 2010 to Dec. 2014 were enrolled for the study. All cases were given close monitoring of thyroid function during pregnancy. Cases with the abnormal results were given appropriate treatment and monitoring,then the maternal and infant outcomes of all cases were recorded. Results Among the 3152 pregnant women,2642 cases （ 83.8 % ） had normal thyroid function,58 cases （ 1.8 % ） had hyperthyroidism, 40 eases （ 1.3% ） had hypothyroidism, 46 eases （ 1.5% ） had subclinical hyperthyroidism, 208 cases （6. 6% ） had subclinical hypothyroidism （SCH） and 158 cases （5.0%） had isolated hypothyroxinemia. The incidences of gestational diabetes mellitus（GDM） and pregnancy induced hypertension（PIH） in the hyper- thyroidism group, macrosomia incidence in the hypothyroidism group, GDM in the subclinical hyperthyroidism group, preterm birth in the SCH group were 27.6% （ 16/58 ）, 8.6% （5/58）, 10.0% （4/40） ,34. 8% （ 16/ 46） ,13.5% （28/208） respectively,which were significantly higher than 16. 1% （425/2642） ,2.8% （75/ 2642） ,2.5% （60/2642） ,16. 1% （425/2642） ,7.7% （202/2642） of normal thyroid function group（P 〈 0. 05 ）. Conclusion Thyroid function of pregnant women is associated with pregnancy outcomes. Different types of thyroid disease may increase the risk of GDM, PIH, macrosomia and preterm birth. We should be actively monitor the thyroid function of pregnant women and to give appropriate treatment.