3 513例妊娠早期妇女TPOAb阳性与不良妊娠结局的关系

Relationship Between TPOAb Positive and Adverse Pregnancy Outcome in 3 513 Cases of Early Pregnancy Women

目的探讨妊娠早期母体甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)阳性与妊娠不良结局的关系。方法选取2012年9月-2017年9月来本院初次产检的妊娠早期妇女,按纳入标准选取研究对象,对其进行甲状腺激素水平检测。并对TSH≥0.3 uIU/mL的孕妇进行追踪随访,记录其妊娠结局,再根据检测结果将其分为甲状腺功能正常组、甲状腺功能减退(甲减)组,并进一步划分为TPOAb阳性和TPOAb阴性组,分析每组不良妊娠结局的发生率。结果甲状腺功能正常组中TPOAb阳性组不良妊娠结局发生率显著高于阴性组,差异有统计学意义(P<0.05);甲减组中TPOAb阳性组不良妊娠结局发生率显著高于阴性组,差异有统计学意义(P<0.05);TPOAb阳性组不良妊娠结局发生率显著高于阴性组,差异有统计学意义(P<0.05)。结论孕期TPOAb检测对预防妊娠不良结局有重大意义。建议定期检测妊娠期妇女的甲状腺激素水平,以避免不良妊娠结局的发生。

Objective To investigate the relationship between maternal thyroid peroxidase antibody(TPOAb)positive and adverse pregnancy outcomes in early pregnancy.Methods The early pregnancy women who came to the hospital for the first inspection from September 2012 to September 2017 were selected,the research subjects were selected according to the inclusion criteria,and the thyroid hormone levels were determined.The pregnant women with TSH no less than 0.3 uIU/mL were followed up to record their pregnancy outcome.According to the inspection results,they were divided into the normal thyroid function group,hypothyroidism group,and further divided into the TPOAb positive and the TPOAb negative groups.The incidence of adverse pregnancy outcomes in each group was analyzed.Results In the normal thyroid function group,the incidence of adverse pregnancy outcome in TPOAb positive group was signifcantly higher than that in negative group,the diference was statistically significant(P<0.05).In the hypothyroidism group,the incidence of adverse pregnancy outcomes in the TPOAb-positive group was significantly higher than that in the negative group.The difference was statistically significant(P<0.05).In total,the incidence of adverse pregnancy outcomes in the TPOAb-positive group was signifcantly higher than that in the negative group, the diference was statistically signifcant (P< 0.05). Conclusion The detection of TPOAb during pregnancy is of greatsignifcance in preventing the adverse outcome of pregnancy. It is suggestedthat thyroid hormone levels in pregnant women should be measuredregularly to avoid adverse pregnancy outcomes.