甲状腺自身抗体对妊娠结局的影响

Influence of Serum Thyroid Antibody with Euthyroidism on Pregnancy Outcome

目的：观察妊娠早期单纯甲状腺过氧化物酶抗体（thyroid peroxidase antibody,TPO-Ab）阳性,是否会增加孕产妇妊娠并发症的发生和影响妊娠结局。方法：收集孕周≤13周且甲状腺功能正常孕妇的临床资料,根据TPO-Ab检测结果将患者分为TPO-Ab（-）组（〈60 k U/L,793例）和TPO-Ab（＋）组（≥60 k U/L,88例）。随访患者甲状腺功能的变化,比较2组患者妊娠结局的差异。结果：TPO-Ab（＋）组患者促甲状腺激素（TSH）高于TPO-Ab（-）组（t=2.079,P=0.038）;TPO-Ab（＋）组患者胎膜早破、胎儿生长受限（FGR）和低出生体质量儿的发生率高于TPO-Ab（-）组（7.95%vs.1.89%,χ^2=9.598,P=0.002;2.27%vs.0.37%,χ^2=5.126,P=0.024;5.68%vs.2.12%,χ^2=4.180,P=0.041）。结论：TPO-Ab阳性对妊娠期间并发症和妊娠结局存在不良影响。

Objective：To investigate whether pure serum thyroid peroxidase antibody（TPO-Ab） positive in early gestation women with euthyroidism can influence their pregnancy complications and outcomes. Methods：The clinical data of pregnant women with euthyroidism and gestational age were less than 13 weeks in our hospital was collected. All subjects were divided into two groups,on basis of TPO-Ab negative-TPO-Ab group（ 60 kU/L, 793 cases）, positive-TPO-Ab group（ ≥60 k U/L,88 cases）. Follow up the change of thyroid function, compare the difference of pregnancy outcome in two groups. Results：The serum level of TSH in positive-TPO-Ab group was higher than negative-TPO-Ab group（t=2.079, P =0.038）. The incidence rate of premature rupture of membrane, fetal growth restriction（FGR） and infant of low-birth weight in positive-TPO-Ab group were higher than negative-TPO-Ab group（7.95% vs. 1.89%, χ~2=9.598, P=0.002; 2.27% vs. 0.37%, χ~2=5.126, P=0.024; 5.68%vs. 2.12%, χ~2=4.180, P =0.041）. Conclusions：Positive-TPO-Ab was likely to have adverse effect on pregnancy complications and outcomes.