摘要:
目的：探讨孕产妇甲状腺功能异常对妊娠结局的影响。方法：选择3 778例无甲状腺疾病史孕产妇，初诊时对其甲状腺功能进行检查，依据筛查结果，分为甲状腺功能亢进（甲亢）组、甲状腺功能减退（甲减）组、亚甲减组、其他甲状腺疾病组和正常对照组。对各组孕产妇的妊娠过程及结局进行分析。结果：甲亢组、甲减组、亚甲减组、低甲状腺素血症组早产率均显著高于正常对照组（P<0.01）；各组不良结局发生率均高于正常对照组（P<0.01）；甲亢组、甲减组、亚甲减组、低甲状腺素血症组新生儿5 min Apgar评分与正常对照组差异均无统计学意义（P>0.05），但甲亢组和甲减组新生儿体质量均低于正常对照组（P<0.01）；各组甲状腺功能异常孕产妇胎儿窘迫、胎儿生长受限、妊娠期高血压疾病及产后感染的发生率与正常对照组差异均有统计学意义（P<0.01），其中甲亢组、甲减组和亚甲减组胎儿窘迫的发生率均高于正常对照组（P<0.05~P<0.01），甲亢组和甲减组妊娠期高血压疾病发生率均高于正常对照组（P<0.01）。结论：定期对孕产妇的游离三碘甲状腺原氨酸、游离甲状腺素、促甲状腺激素进行检测，了解甲状腺功能，有利于减少产科并发症的发生，对改善妊娠结局有着重要的意义。
Abstract:
Objective: To explore the effects of abnormal thyroid function on the pregnancy outcome.Methods: Three thousand seven hundred and seventy-eight pregnant women without the history of thyroid disease were divided into the hyperthyroidism group,hypothyreosis group,subclinical hypothyreosis group,other thyroid disease group and normal control group according to the thyroid function.The processes and outcomes of pregnancy between all groups were analyzed and compared.Results: The preterm delivery rates of the hyperthyroidism group,hypothyreosis group,subclinical hypothyreosis group and low thyroid group were significantly higher than that of the normal group(P<0.01).The incidence of adverse outcome in all groups were higher than that in normal control group(P<0.01).The differences of the neonatal 5 min Apgar scores between the hyperthyroidism group,hypothyreosis group,subclinical hypothyreosis group,low thyroid group and normal control group were not statistically significant(P>0.05),the neonatal weights in hyperthyroidism group and hypothyreosis group were lower than that in normal control group(P<0.01).The differences of the occurrence rates of respiratory distress syndrome,intrauterine growth retardation,hypertensive disorder complicating pregnancy and postpartum infection between pregnant with abnormal thyroid function and normal control group were statistically significant(P<0.01).The incidence of respiratory distress syndrome in hyperthyroidism group,hypothyreosis group and subclinical hypothyreosis group,and the incidence of hypertensive disorders in hyperthyroidism group and hypothyroidism group were higher than those in normal control group(P<0.01).Conclusions: The regular testing of FT3,FT4 and thyroid stimulating hormone is very helpful to know the thyroid function of pregnant,which can induce the complications and improve the pregnancy outcome.
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