浅析女性在妊娠早期发生亚甲减及TPO-Ab阳性对其妊娠结局的影响

The effects of hypothyroidism in the first trimester of pregnancy and tpo-ab positive on the outcome of pregnancy were analyzed

目的:探讨女性在妊娠早期发生亚临床甲状腺功能减退(简称亚甲减)及抗甲状腺过氧化物酶抗体(TPO-Ab)阳性对其妊娠结局的影响。方法:选取2018年1月至2019年1月期间在连云港市妇幼保健院建立档案并分娩的孕妇作为研究对象。将其中40例在妊娠早期患有亚甲减的女性作为试验1组,将其中40例在妊娠早期进行TPO-Ab试验的结果为阳性的女性作为试验2组,将其中40例健康妊娠期女性作为对照组。分析三组女性的临床资料。观察三组女性血清游离三碘甲腺原氨酸(FT_3)的水平、血清游离甲状腺素(FT4)的水平、血清促甲状腺激素(TSH)的水平、发生不良妊娠结局的情况及其所娩新生儿发生不良结局的情况。结果:试验1组女性血清TSH的水平及妊娠期糖尿病的发生率均高于对照组女性,其所娩新生儿窒息的发生率高于对照组女性所娩的新生儿,P<0.05。试验2组女性胎儿宫内窘迫的发生率高于对照组女性,其所娩新生儿窒息的发生率高于对照组女性所娩的新生儿,P<0.05。结论:女性在妊娠早期发生亚甲减及TPO-Ab阳性易导致其发生不良的妊娠结局,其所娩新生儿不良结局的发生率较高。

objective:to investigate the effect of subclinical hypothyroidism(hypothyroidism)and positive anti-thyroid peroxidase antibody(tpo-ab)in early pregnancy on pregnancy outcome in women.Methods:pregnant women who had established archives and delivered in lianyungang maternal and child health hospital between January 2018 and January 2019 were selected as subjects.Among them,40 women with hypothyroidism in the first trimester were selected as the test group 1,40 women with positive results of tpo-ab test in the first trimester were selected as the test group 2,and 40 healthy pregnant women were selected as the control group.Clinical data of three groups of women were analyzed.The serum levels of free triiodine-methyl-adenosine(FT3),serum free thyroxine(FT4),serum thyrotrophin(TSH),adverse pregnancy outcomes and adverse neonatal outcomes were observed in the three groups of women.Results:the level of serum TSH and the incidence of gestational diabetes were higher in the first group than in the control group,and the incidence of neonatal asphyxia was higher in the control group than in the control group(P<0.05).The incidence of fetal distress in the 2 groups was higher than that in the control group,and the incidence of neonatal asphyxia was higher than that in the control group(P<0.05).Conclusion:the incidence of hypothyroidism and tpo-ab positive in the first trimester of pregnancy is likely to lead to adverse pregnancy outcomes,and the incidence of adverse neonatal outcomes is higher.