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目的:研究妊娠晚期合并亚临床甲状腺功能减退症(subclinical hypothyroidism,SCH)对妊娠和胎儿的影响。方法:选择2008年1月—2013年6月经甲状腺功能筛查诊断为SCH的妊娠晚期妇女56例作为观察组,甲状腺功能正常且无其他合并症的同期妊娠妇女95例作为对照组。比较分析观察组和对照组,以及观察组中甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)阳性孕妇15例和阴性孕妇41例的妊娠结局、妊娠合并症及并发症的差异。结果:观察组早产发生率23.21%,死胎发生率1.79%,足月产率为75.00%,观察组早产率、死胎发生率均明显高于对照组(P<0.05);观察组妊娠合并贫血发生率76.79%,妊娠期糖代谢异常发生率48.21%,妊娠期高血压疾病发生率23.21%,胎盘早剥发生率10.71%,出生低体重儿发生率为12.50%,均明显高于对照组(P<0.05);观察组中TPOAb阳性孕妇早产发生率60.00%,妊娠期高血压疾病发生率53.33%,均高于TPOAb阴性孕妇(P<0.05);总体不良妊娠结局发生率,TPOAb阳性孕妇为66.67%,阴性孕妇为63.41%,两者之间差异无统计学意义(P>0.05)。结论:妊娠晚期SCH会增加不良妊娠结局、妊娠并发症及合并症的发病风险,早期发现SCH并及时治疗可降低妊娠合并症和并发症,减少不良妊娠结局。
Objective: To study the effects of subclinical hypothyroidism (SCH) in pregnancy and pregnancy on pregnancy and fetus. Methods: From January 2008 to June 2013, 56 pregnant women with SCH diagnosed by thyroid function screening were enrolled in this study. 95 pregnant women with normal thyroid function and no other complications were selected as the control group. The pregnancy outcome, pregnancy complications and complications of 15 cases of thyroid peroxidase antibody (TPOAb) -positive pregnant women and 41 cases of negative pregnant women in the observation group and the control group were compared. Results: The incidence of preterm birth in observation group was 23.21%, the incidence of stillbirth was 1.79%, and the full-term birth rate was 75.00%. The incidences of preterm birth and stillbirth in observation group were significantly higher than those in control group (P <0.05) The rate of abnormal glucose metabolism in pregnancy was 48.21%, the incidence of hypertensive disorders in pregnancy was 23.21%, the incidence of placental abruption was 10.71%, the incidence of low birth weight infants was 12.50%, which were significantly higher than that of the control group (P <0.05). The prevalence of preterm birth and TPOAb-positive pregnant women in the observation group were 60.00% and 53.33%, respectively, higher than that of TPOAb-negative pregnant women (P <0.05). The overall incidence of adverse pregnancy outcomes was 66.67 %, Negative pregnant women was 63.41%, no significant difference between the two (P> 0.05). CONCLUSIONS: SCH in the third trimester of pregnancy increases the risk of adverse pregnancy outcomes, pregnancy complications and complications. Early detection of SCH and timely treatment may reduce the complications and complications of pregnancy and reduce the adverse pregnancy outcomes.