妊娠期亚临床甲状腺功能减退与后代智力水平及孕前体重指数的相关性分析

Analysis on the correlation between subclinical hypothyroidism during pregnancy and intelligence level of offsprings and prepregnancy body mass index

目的分析妊娠期亚临床甲状腺功能减退症(SCH)与后代智力水平的相关性,并探讨其影响因素。方法选取该院2012年6月-2015年6月收治的74例妊娠期SCH及同期50例甲状腺功能正常的健康产妇,分别纳入观察组、对照组,比较两组产妇后代月龄达12个月时盖瑟尔智力测评结果,分析妊娠期SCH与后代智力水平的相关性;比较两组产妇年龄、产次等一般临床资料,将差异存在统计学意义的因素纳入Logistic多因素回归分析,总结影响妊娠期SCH发生的影响因素。结果观察组后代大运动发育商(GMQ)、语言发育商(LQ)、个人社交发育商(ISBQ)低于对照组后代,差异有统计学意义(t=12.703、26.366、29.015,P<0.05),两组产妇后代适应性行为发育商(ABQ)、精细动作发育商(FMQ)比较,差异无统计学意义(t=1.533、1.654,P>0.05)。多因素分析显示,孕前体重指数(BMI)<18.5 kg/m^2是导致妊娠期SCH发生的独立危险因素,年龄<25岁为保护性因素(P<0.05)。结论妊娠期SCH可对后代智力水平造成明显不良影响,针对孕前BMI较低这个独立危险因素实施早期干预,同时25岁前妊娠有望降低妊娠期SCH发生风险,保证后代发育质量。

Objective To analyze the correlation between subclinical hypothyroidism（ SCH） during pregnancy and intelligence level of offsprings,explore the influencing factors. Methods Seventy-four pregnant women with SCH（ observation group） and fifty healthy pregnant women with normal thyroid function（ control group） were selected from the hospital from June 2012 to June 2015. Gessel intelligence assessment results of their babies at 12 months in the two groups were compared. The correlation between SCH during pregnancy and intelligence level of offsprings was analyzed. The general clinical data was compared between the two groups,such as age,parity. The factors with statistically significant difference entered into multivariate logistic regression analysis,the influencing factors of SCH during pregnancy were summarized. Results Gross motor development quotient（ GMQ）,language development quotient（ LQ）,and individual social development quotient（ ISBQ） of offsprings in observation group were statistically significantly lower than those in control group（ t = 12. 703,26. 366,29. 015,P〈0. 05）. There was no statistically significant difference in adaptive behavior development quotient（ ABQ） and fine movement development quotient（ FMQ） of offsprings between the two groups（ t = 1. 533,1. 654,P〉0. 05）. Multivariate analysis showed that prepregnancy body mass index（ BMI） 18. 5 kg/m^2 was the independent risk factor for SCH during pregnancy,age less than 25 years was the protective factor（ P〈0. 05）. Conclusion SCH during pregnancy can cause significant adverse effects on intelligence level of the offsprings,early intervention targeting to low prepregnancy BMI should be implemented,getting pregnancy before the age of 25 is expected to reduce the risk of SCH during pregnancy to ensure development quality of the offsprings.