妊娠期妇女甲减与亚甲减对妊娠结局和胎儿影响的分析对比研究

Comparative analysis of the effect of hypothyroidism and subhypothyroidism on pregnancy outcome and fetus in pregnant women

目的分析比较妊娠期妇女甲状腺功能减退(以下简称“甲减”)和亚临床甲状腺功能减退(以下简称“亚甲减”)对妊娠结局和胎儿影响。方法选取2016年7月—2019年6月南通大学附属如皋医院收治的行产前检查并分娩的80例孕妇作为研究对象,受试者在孕10周患者均行甲状腺功能检查,根据结果将其分为亚甲减组(30例),甲减组(50例)。比较两组妊娠结局和胎儿不良结局。结果两组妊娠期高血压疾病、产后出血、胎膜早破、早产、贫血发生率比较,差异无统计学意义(P>0.05);亚甲减组妊娠期糖尿病发生率明显高于甲减组,差异有统计学意义(P<0.05)。两组均无前置胎盘及胎盘早剥情况发生。两组均无低出生体重儿;两组畸形和胎儿窘迫发生率、5 min Apgar评分比较,差异无统计学意义(P>0.05)。结论妊娠期妇女甲减和亚甲减均可对妊娠结局和胎儿造成不良影响,对孕妇躯体和胎儿发育均存在不利因素,亚甲减在某些妊娠和胎儿不良结局上相对增高,临床早期筛查甲状腺功能并实施相关干预措施十分关键。

Objective To analyze and compare the effect of hypothyroidism(“hypothyroidism”for short)and sub-clinical hypothyroidism(“subhypothyroidism”for short)on pregnancy outcome and fetus in pregnant women.Methods From July 2016 to June 2019,80 cases of pregnant women who received prenatal examination and gave birth in Rugao People’s Hospital Affiliated to Nantong University were selected as the research objects.Ten weeks of pregnancy patients were performed thyroid function,and they were divided into subhypothyroidism group(30 cases)and hypothyroidism group(50 cases).The pregnancy outcomes and fetal adverse outcomes were compared between the two groups.Results There were no statistically significant differences in the incidence of hypertensive disease during pregnancy,postpartum hemorrhage,premature rupture of membranes,preterm delivery and anemia between two groups(P>0.05);the incidence of gestational diabetes in subthyroidism group were significantly higher than those in hypothyroidism group(P<0.05).No placenta previa or placental abruption occurred in both groups.There were no low birth weight infants between two groups.There were no statistically significant differences in the incidence of malformation and fetal distress,5 min Apgar score(P>0.05).Conclusion Both hypothyroidism and subhypothyroidism in pregnant women have adverse effects on pregnancy outcome and fetus,and have adverse factors on the physical and fetal development of pregnant women.Subhypothyroidism is relatively higher in some pregnancies and fetal adverse outcomes,so it is very important to screen thyroid function in early clinical stage and implement relevant intervention measures.