文章摘要
侯美芹,王治洁,侯克柱.妊娠期妇女甲状腺功能减退对妊娠结局和胎儿影响的分析[J].中华流行病学杂志,2016,37(5):722-724
妊娠期妇女甲状腺功能减退对妊娠结局和胎儿影响的分析
Influence of hypothyroidism on pregnancy outcome and fetus during pregnancy
收稿日期:2015-12-30  出版日期:2016-05-13
DOI:10.3760/cma.j.issn.0254-6450.2016.05.028
中文关键词: 甲状腺功能减退;妊娠期;分娩;胎儿
英文关键词: Hypothyroidism;Pregnancy;Labor;Fetus
基金项目:上海市卫生与计划委员会课题(201440014)
作者单位E-mail
侯美芹 200235 上海市第八人民医院妇产科 houmeiqin13@163.com 
王治洁 200235 上海市第八人民医院妇产科  
侯克柱 200438 上海市东医院外科  
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中文摘要:
      目的 分析妊娠期妇女甲状腺功能减退(甲减)对妊娠结局和胎儿的影响。方法 选择2013年1月至2015年10月在上海市第八人民医院行产前检查并分娩的4286例孕妇为研究对象,入组患者均在孕10周时行甲状腺功能检查,分为甲减、亚临床甲状腺功能减退(亚甲减)和健康3组,分析甲减发生状况及其对妊娠结局和胎儿的影响。结果 共检出甲减209例,发生率为4.9%(209/4286),其中临床甲减85例,亚甲减124例。健康组早产发生率(1.0%)明显低于甲减组(10.6%)和亚甲减组(6.5%),差异有统计学意义(χ2=38.884,P<0.001;χ2=17.722,P<0.001);健康组贫血发生率(3.8%)明显低于甲减组(18.8%)和亚甲减组(9.7%),差异有统计学意义(χ2=30.949,P<0.001;χ2=23.275,P<0.001);健康组低体重发生率(1.1%)明显低于甲减组(14.1%)和亚甲减组(4.8%),差异有统计学意义(χ2=50.593,P<0.001;χ2=15.637,P<0.001);健康组胎儿窘迫发生率(1.9%)明显低于甲减组(10.6%)和亚甲减组(5.6%),差异有统计学意义(χ2=19.257,P<0.001;χ2=12.357,P<0.001);健康组胎儿Apgar评分(9.69±0.32)明显高于甲减组(9.25±0.45)和亚甲减组(9.28±0.44),差异有统计学意义(t=8.823,P<0.001;t=15.175,P<0.001)。结论 妊娠期妇女甲减可对妊娠结局和胎儿构成不利影响,临床应加强妊娠期妇女相关检查,早发现早治疗。
英文摘要:
      Objective To investigate the influence of hypothyroidism on pregnancy outcome and fetus in pregnant women. Methods A total of 4 286 pregnant women, who received prenatal examination in our hospital from January 2013 to October 2015, were selected as study subjects. The incidence of hypothyroidism and the influence on pregnancy outcomes and fetus were investigated. Results In 4 286 pregnant women surveyed, 209 hypothyroidism cases were detected (4.9%), including 85 clinical hypothyroidism cases and 124 subclinical hypothyroidism cases. In health group, the premature delivery rate was 1.0%, significantly lower than that in clinical hypothyroidism group (10.6%) and in subclinical hypothyroidism group (6.5%), the differences were significant (χ2=38.884, P<0.001; χ2=17.722, P<0.001). In healthy group, the incidence of anemia was 3.8%, significantly lower than that in clinical hypothyroidism group (18.8%) and in subclinical hypothyroidism group (9.7%), the differences were significant (χ2=30.949, P<0.001; χ2=23.275, P<0.001). In health group, the incidence of low birth weight was 1.1%, significantly lower than that in clinical hypothyroidism group (14.1%) and in subclinical hypothyroidism group (4.8%), the differences were significant (χ2=50.593, P<0.001; χ2=15.637, P<0.001). In health group, the fetal distress incidence was 1.9%, significantly lower than that in clinical hypothyroidism group (10.6%) and in subclinical hypothyroidism group (5.6%), the differences were significant (χ2=19.257, P<0.001; χ2=12.357, P<0.001). In health group, the fetal Apgar score (9.69±0.32) was significantly higher than those in clinical hypothyroidism group (9.25±0.45) and in subclinical hypothyroidism group (9.28±0.44), the differences were significant (t=8.823, P<0.001; t=15.175, P<0.001). Conclusion Hypothyroidism during pregnancy has adverse influences on pregnancy outcome and fetus, and it is necessary to strengthen the hypothyroidism detection in pregnant women for the early treatment.
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