育龄妇女孕前甲状腺功能检测结果及其影响因素分析

Analysis of thyroid function test results and its influencing factors in women of childbearing age before pregnancy

目的分析育龄妇女孕前优生健康评估中的甲状腺检查结果,探讨血清促甲状腺素(TSH)异常的相关因素。方法选取2018年1月至12月期间在湖州市妇幼保健院计划生育服务指导科进行的免费孕前优生健康检查的育龄妇女2026例为研究对象,分析TSH检测结果,采用多因素Logistic回归分析探讨TSH异常的影响因素。结果2026例育龄妇女中TSH≤0.3mIU/L者30例(1.48%),TSH水平0.31~2.49mIU/L者1824例(90.03%),TSH≥2.5mIU/L者173例(8.54%)。41~47岁妇女TSH≤0.3mIU/L、TSH≥2.5mIU/L者所占比例均最高,分别为2.44%、9.76%,但三个不同年龄段妇女TSH水平构成比差异无统计学意义(χ^(2)值分别为0.108、0.382、0.392,均P>0.05)。TSH正常组、TSH减低组、TSH升高组妇女月经史、不良孕产史、碘摄入情况、甲状腺疾病家族史比较差异有统计学意义(χ^(2)值分别为19.879、43.194、92.020、13.165,均P<0.05),而三组妇女年龄、BMI比较差异均无统计学意义(t值分别为1.109、0.913,均P>0.05)。Logistic回归分析结果显示月经异常、不良孕产史、碘摄入异常、甲状腺疾病家族史是TSH异常的危险因素(OR值分别为1.432、2.108、2.909、2.036,均P<0.05)。结论育龄妇女孕前优生健康评估中TSH降低率、TSH升高率分别为1.48%、8.54%,月经异常、不良孕产史、碘摄入异常、甲状腺疾病家族史是TSH异常的危险因素,应重点关注。

Objective To analyze the results of thyroid examination in pre-pregnancy healthy birth assessment of women of childbearing age,and explore the related factors of abnormal serum thyroid stimulating hormone(TSH)levels.Methods A total of 2026 women of childbearing age who received free pre-pregnancy healthy birth examination in the family planning service guidance department of Huzhou Maternal and Child Health Hospital from January to December 2018 were selected as the research objects.The thyroid examination results were analyzed,and the influencing factors of TSH abnormality were further discussed by multivariate Logistic regression analysis.Results Among the 2026 women of childbearing age,30 cases(1.48%)had serum TSH level≤0.3 mIU/L,1824 cases(90.03%)had serum TSH level between 0.31~2.49 mIU/L,and 173 cases(8.54%)had TSH≥2.5 mIU/L.The proportion of TSH≤0.3 mIU/L and TSH≥2.5 mIU/L in 41~47 years old women was the highest,2.44%and 9.76%,respectively.However,but there was no statistically significant difference in the composition ratio of TSH levels in different age groups(χ^(2) values were 0.108,0.382 and 0.392,respectively,all P>0.05).There were statistically significant differences in menstrual history,adverse pregnancy history,iodine intake and family history of thyroid disease among the TSH normal group,TSH decreased group and TSH elevated group(χ^(2) values were 19.879,43.194,92.020 and 13.165,respectively,all P<0.05),while there were no statistically significant differences in age and BMI among the three groups(t values were 1.109 and 0.913,respectively,all P>0.05).Logistic regression analysis showed that abnormal menstruation,adverse pregnancy history,abnormal iodine intake and family history of thyroid disease were risk factors of abnormal TSH level(OR values were 1.432,2.108,2.909 and 2.036,respectively,all P<0.05).Conclusion In the pre-pregnancy health assessment of women of childbearing age,the rates of TSH decrease and TSH increase were 1.48%and 8.54%,respectively.Abnormal menstruation,adverse pregnancy history,abnormal iodine intake and family history of thyroid disease are risk factors for TSH abnormality,which should be paid more att-ention to.