妊娠期亚临床甲状腺功能减退症对母婴结局的影响

Effects of subclinical hypothyroidism during pregnancy on maternal-infant outcomes

目的探讨妊娠期亚临床甲状腺功能减退症(SCH)对母婴结局的影响。方法回顾性分析2016年11月至2018年11月于郑州市第三人民医院妇产科进行产检并分娩的90例SCH产妇与90例甲状腺功能正常产妇的临床资料,SCH产妇归入SCH组,甲状腺功能正常产妇归入对照组,分析并比较两组产妇妊娠结局、并发症情况及新生儿不良结局。结果SCH组产妇妊娠结局中足月产率低于对照组,早产率、流产率均高于对照组,差异有统计学意义(P<0.05);SCH组并发症(妊娠期高血压综合征、贫血、胎膜早破、肝内胆汁淤积)发生率均高于对照组,差异有统计学意义(P<0.05);两组妊娠期糖尿病、前置胎盘、胎盘早剥、产后出血发生率比较差异未见统计学意义(P>0.05);产妇分娩后,SCH组新生儿不良结局(胎儿生长受限、胎儿窘迫)发生率高于对照组,差异有统计学意义(P<0.05);两组巨大儿、低体质量儿、新生儿窒息、死胎发生率比较差异未见统计学意义(P>0.05)。结论SCH可增加母婴不良结局发生风险,于妊娠早期进行甲状腺功能筛查,对SCH孕妇进行对应治疗以降低母婴不良结局发生十分必要。

Objective To explore the effects of subclinical hypothyroidism (SCH) during pregnancy on maternal-infant outcomes. Methods Clinical data of 90 SCH puerperae and 90 puerperae with normal thyroid function who had production inspection and delivered in Department of Obstetrics and Gynecology of Zhengzhou Third People’s Hospital from November 2016 to November 2018 were retrospectively analyzed. SCH puerperae were included in SCH group, and puerperae with normal thyroid function were assigned to control group. Pregnancy outcomes and complications of puerperae and neonatal adverse outcomes were analyzed in the two groups. Results The full-term yield of maternal pregnancy outcomes in SCH group was lower than that in control group, and the preterm birth rate and abortion rate were higher than those in control group (P<0.05). The incidences of complications (pregnancy-induced hypertension, anemia, premature rupture of membranes, intrahepatic cholestasis of pregnancy) in SCH group were higher than those in control group (P<0.05). There were no statistically significant differences in the incidence rates of gestational diabetes mellitus, placenta previa, placental abruption and postpartum hemorrhage between the two groups (P>0.05). After delivery, the incidences of neonatal adverse outcomes (fetal growth restriction, fetal distress) in SCH group were higher than those in control group (P<0.05). There were no significant differences in the incidences of fetal macrosomia, low birth weight infant, neonatal asphyxia and stillbirth between the two groups (P>0.05). Conclusions SCH can increase the risk of maternal-infant adverse outcomes. Thyroid function screening in early pregnancy is necessary in the treatment of pregnant women with SCH, and it reduce the maternal-infant adverse outcomes.