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

侯美芹; 王治洁; 侯克柱

Abstract

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].Chinese journal of Epidemiology,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

Received:December 30, 2015

DOI：10.3760/cma.j.issn.0254-6450.2016.05.028

KeyWord: 甲状腺功能减退妊娠期分娩胎儿

English Key Word: Hypothyroidism Pregnancy Labor Fetus

FundProject:上海市卫生与计划委员会课题(201440014)

Author Name	Affiliation	E-mail
Hou Meiqin	Department of Gynecology and Obstetrics, the Eighth People's Hospital of Shanghai, Shanghai 200235, China	houmeiqin13@163.com
Wang Zhijie	Department of Gynecology and Obstetrics, the Eighth People's Hospital of Shanghai, Shanghai 200235, China
Hou Kezhu	Department of Surgery, Shanghai East Hospital, Shanghai 200438, China

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Abstract:

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。

English Abstract:

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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