妊娠期甲亢类型分析及对母婴结局的影响

Analysis of types of hyperthyroidism in pregnancy and its effects on maternal and neonatal outcomes

目的:分析妊娠期甲亢的类型并探讨其对母婴结局的影响。方法:选取甲亢孕妇300例,进行甲亢类型的分析。根据诊断标准确定Graves’病(Graves’disease,GD)108例(GD组)、妊娠期一过性甲亢(gestational transient thyrotoxicosis,GTT)104例(GTT组)和桥本甲亢33例(桥本甲亢组)作为最终研究对象,选取同期正常妊娠孕妇340例作为对照,分析孕妇甲状腺功能变化及对母婴结局的影响。结果:(1)300例甲亢孕妇中,有36.00%(108/300)为GD,34.67%(104/300)为GTT,11.00%(33/300)为桥本甲亢;(2)GD组持续甲亢的比例高于GTT组(P <0.05);(3)GD组出现妊娠期高血压、子痫前期、早产儿及新生儿甲减的比例高于GTT组和对照组(P <0.05)。结论:有活动性GD或既往甲亢病史的妇女,孕前合理咨询及计划妊娠可减少母婴不良结局的发生。

Objective:This study aims to analyze the types of hyperthyroidism in pregnancy and to investigate its effects on pregnancy outcomes. Methods:Total 300 pregnant women were enrolled,who were diagnosed as hyperthyroidism in this study. To analyze the types of hyperthyroidism in pregnancy,according to the diagnostic criteria,there were 108 cases in Graves’ disease(GD)group,104 cases in gestationgal transient thyrotoxicosis(GTT)group,and 33 cases in hashitoxicosis group. Then 340 normal pregnant women were selected for control. The changes of thyroid function in pregnancy and its effects on the adverse outcomes of mothers and offspring in different groups were analyzed. Results:Of 300 pregnant women with hyperthyroidism,41.67% had hyperthyroidism before pregnancy and 58.33% were diagnosed with hyperthyroidism during pregnancy. Among 300 women,36.00% were GD,34.67%were GTT and 11.00% were hashitoxicosis. The proportion of pregnant women who have persistent hyperthyroidism was significantly higher in GD group than in GTT group. The incidences of pregnancy-induced hypertension,preeclampsia,preterm birth,and neonatal hypothyroidism were significantly higher in GD group than those in GTT group or in the control group. Conclusion:For women with active GD or previous history of hyperthyroidism,reasonable pre-pregnancy counseling and pregnancy planning are of great significance to reduce the occurrence of adverse outcomes of mothers and offspring.