妊娠晚期亚临床甲减及TPO-Ab对妊娠结局的影响

The effect of late pregnancy subclinical hypothyroidism and TPO-Ab on pregnancy outcome

目的:探讨妊娠晚期亚临床甲减及TPO-Ab对妊娠结局的影响。方法:回顾性分析2011年8月至2013年2月湖南省人民院109名孕妇的病历资料。亚临床甲减组(A组)42例,其中TPO-Ab阳性(A1组)6例,TPO-Ab阴性(A2组)36例;正常对照组(B组)67例,其中TPO-Ab阳性(B1组)12例,TPO-Ab阴性(B2组)55例。分析其年龄、心率等一般资料,空腹血糖、甲状腺功能及TPO-Ab等生化指标,评估母亲和胎儿合并症。结果:1.亚临床甲减组平均心率较正常对照组偏低,差异有统计学意义,但两组在其他一般情况、生化指标、孕妇代谢指标及新生儿出生时情况等方面的无明显差异。2.亚临床甲减组较正常对照组胎儿合并症及胎儿窘迫发生风险均增加,差异有统计学意义,但两组母亲合并症没有区别。3.亚临床甲减合并TPO-Ab阳性组与合并TPO-Ab阴性组比较,母亲合并症、胎儿合并症、胎膜早破、胎儿窘迫、早产的发生率均升高,且差异有统计学意义。结论:妊娠晚期亚临床甲减,尤其是合并有TPO-Ab阳性者是妊娠的高危因素,可导致不良妊娠结局发生率增高。

Objective To observe the effect of late pregnancy subclinical hypothyroidism and TPOAb on pregnancy outcome.Methods Collecting the gravida information of the People's Hospital of Hunan Province from Augest 2011 to February 2013. The case group(A group)has 42 subjects,control group (B group) has 67 subjects. Analyzing the clinical data,thyroid function,TPO-Ab and other biochemical indicators,meanwhile assessing the maternal and fetal complications.Results 1. The average levels of heart rate in A group were slightly slower than those of the control group, and the differences between them had statistical significance.But the differences be-tween A group and B group in other clinical data, biochemical markers had no statistical significance.2. Fetal complications and fetal distress both increased in A group than those of control group,but there were no statisti-cally significant differences in maternal complications.3. Fetal complications, Maternal complications, Premature rupture of membranes, fetal distress and premature all increased in A group than those of control group.Conclu-sion subclinical hypothyroidism and TPO-Ab positive in late pregnancy are high-risk factors of pregnancy.