绍兴市妊娠期妇女合并甲状腺功能减退发生情况及影响因素分析

Analysis of incidence and influencing factors of hypothyroidism in pregnant women in Shaoxing City

目的 调查绍兴市新昌县人民医院妊娠期妇女合并甲状腺功能减退(甲减)的发生情况,分析影响疾病的相关因素。方法 选取2019年3月-2023年6月期间该院2 425例妊娠期妇女为研究对象,根据是否合并甲减分为甲减组224例和无甲减组2 201例,记录临床资料,比较甲减组和无甲减组临床资料,采用logistic多因素回归分析妊娠期妇女合并甲减的影响因素。结果 2 425例妊娠期妇女甲减发生率为9.24%,其中合并临床甲减42例,合并亚临床甲减182例。甲减组年龄≥35岁、文化程度初中及以下、有甲状腺疾病家族史、有自然流产史、有妊娠期糖尿病、碘摄入不足,甲状腺过氧化物酶抗体(TPOAb)阳性患者比例显著高于无甲减组,差异有统计学意义(P<0.05)。年龄≥35岁、文化程度初中及以下、有甲状腺疾病家族史、有自然流产史、有妊娠期糖尿病、碘摄入不足、TPOAb阳性均是妊娠期妇女合并甲减的独立危险因素(P<0.05)。甲减组胎盘早破、胎儿窘迫、剖宫产比例显著高于无甲减组,差异有统计学意义(P<0.05)。结论 2 425例妊娠期妇女中,224例合并甲减,发生率为9.24%,年龄、文化程度、甲状腺疾病家族史、自然流产史、妊娠期糖尿病、碘摄入不足、TPOAb阳性为合并甲减的危险因素,需引起临床警惕。

Objective To investigate the incidence of hypothyroidism among pregnant women in Xinchang County People's Hospital of Shaoxing City,and analyze the related factors affecting the disease.Methods From March 2019 to June 2023,2425 pregnant women in the Hospital were collected as research subjects,according to whether hypothyroidism was combined,there were 224 cases in the hypothyroidism group and 2201 cases in the non hypothyroidism group,clinical data were recorded and compared between the hypothyroidism group and the non hypothyroidism group,and logistic regression was applied to analyze the influencing factors of hypothyroidism in pregnant women.Results The incidence of hypothyroidism in 2425 pregnant women was 9.24%,including 42 cases with clinical hypothyroidism and 182 cases with subclinical hypothyroidism.In hypothyroidism group,the proportion of age≥35 years old,educational level of junior high school and below,family history of thyroid disease,history of spontaneous abortion,pregnancy diabetes,insufficient iodine intake,and positive thyroid peroxidase antibody(TPOAb)was obviously higher than that in non hypothyroidism group(P<0.05).Age≥35 years old,educational level of junior high school and below,family history of thyroid disease,history of spontaneous abortion,pregnancy diabetes,insufficient iodine intake,and TPOAb positive were all independent risk factors for hypothyroidism in pregnant women(P<0.05).The proportions of premature rupture of placenta,fetal distress and caesarean section in hypothyroidism group were obviously higher than those in non hypothyroidism group(P<0.05).Conclusion Among 2425 pregnant women,224 cases were associated with hypothyroidism,with an incidence of 9.24%.Age,education level,family history of thyroid disease,history of spontaneous abortion,pregnancy diabetes,insufficient iodine intake and positive TPOAb were the risk factors for hypothyroidism,which should arouse clinical vigilance.