妊娠晚期亚临床甲状腺功能减退症危险因素分析

Analysis of risk factors for subclinical hypothyroidism in late pregnancy

目的 分析妊娠晚期亚临床甲状腺功能减退症(SCH)的危险因素。方法 分析黄南藏族自治州(黄南州)712例妊娠晚期孕妇的临床资料。其中,患有SCH孕妇116例(病例组),甲状腺功能正常孕妇596例(对照组)。比较两组临床和实验室指标。采用多因素logistic回归分析妊娠晚期孕妇SCH的独立危险因素。结果 与对照组相比,病例组孕妇妊娠晚期收缩压和TSH水平较高,FT4水平和新生儿体重较低,藏族、妊娠期贫血、妊娠期高血压、小于孕龄儿和出生男婴比例较高(P<0.05)。多因素logistic回归分析结果显示,有妊娠期高血压、小于孕龄儿及男婴是妊娠晚期孕妇SCH的独立危险因素(P<0.05)。结论 在医疗资源缺乏、经济实力不足的黄南州,对于患妊娠期高血压、小于孕龄儿和孕育男婴的高风险孕妇应尽早进行甲状腺功能筛查,以降低母婴不良妊娠结局的发生。

Objective To analyze the risk factors for subclinical hypothyroidism(SCH)in late pregnancy.Methods The clinical data of 712 pregnant women in late pregnancy living in Huangnan Tibetan Autonomous Prefecture were analyzed,of whom 116 cases were with SCH(group A)and 596 cases were with normal thyroid function(group B).The clinical and laboratory indicators were compared between the two groups.Multivariate logistic regression was used to analyze the risk factors for SCH in late pregnancy.Results Compared with group B,the levels of systolic blood pressure and TSH in late pregnancy were higher,the levels of FT4 and newborn weight were lower,and the proportions of Tibetan,gestational anemia,gestational hypertension,small for gestational age and male infants were higher in group A(P<0.05).The results of multivariate logistic regression analysis showed that gestational hypertension,small for gestational age and male infants were the independent risk factors for SCH in late pregnancy(P<0.05).Conclusion In Huangnan Tibetan Autonomous Prefecture with limited medical resources and poor economic power,thyroid function screening should be performed as early as possible in high-risk pregnant women with gestational hypertension,small for gestational age and male infants to reduce the occurrence of adverse maternal and infant pregnancy outcomes.