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目的探讨甲状腺功能减退对于妊娠结局的影响。方法选择2011年1月至2014年12月30例妊娠伴发甲状腺功能减退的孕妇作为实验组,选择同时期的30例正常孕妇作为对照组,监测两组受试者在不同时期的促甲状腺激素水平(TSH)、血清游离三碘甲腺原氨酸(FT3)、血清游离甲状腺素(FT4)及其妊娠结局,并分析其相关性。结果实验组孕产妇在孕早期、孕中期的TSH明显高于对照组(P<0.05);实验组孕产妇在孕早期、孕中期的FT3和FT4浓度明显低于对照组(P<0.05)。实验组产妇的产后出血率、剖宫产、早产、羊水过多、自发性流产、妊高症、宫内感染的发生率明显高于对照组(P<0.05)。实验组围产儿的胎儿窘迫、巨大儿、新生儿窒息、高胆红素血症、死胎的发生率明显高于对照组(P<0.05)。新生儿体重明显低于对照组(P<0.05)。结论妊娠伴发甲状腺功能减退对妊娠结局及胎儿有不良影响,在临床实践中应该加强监测,必要时采取干预措施,降低不良妊娠结局的发生率。
Objective To investigate the effect of hypothyroidism on pregnancy outcome. Methods From January 2011 to December 2014, 30 pregnant women with concomitant hypothyroidism during pregnancy were selected as the experimental group. Thirty normal pregnant women of the same period were selected as the control group. The levels of thyrotropin (TSH), serum free triiodothyronine (FT3), serum free thyroxine (FT4) and their pregnancy outcomes were analyzed and their correlations were analyzed. Results The serum levels of FT3 and FT4 in pregnant women in the experimental group were significantly higher than those in the control group (P <0.05). The levels of FT3 and FT4 in the pregnant and pregnant women in the experimental group were significantly lower than those in the control group (P <0.05). The incidence of postpartum hemorrhage, cesarean section, premature delivery, polyhydramnios, spontaneous abortion, pregnancy induced hypertension and intrauterine infection in experimental group were significantly higher than those in control group (P <0.05). Fetal distress, macrosomia, neonatal asphyxia, hyperbilirubinemia and stillbirth in the experimental group were significantly higher than those in the control group (P <0.05). Neonatal weight was significantly lower than the control group (P <0.05). Conclusions Pregnancy associated with hypothyroidism has adverse effects on pregnancy outcome and fetus. In clinical practice, surveillance should be strengthened and if necessary, interventions should be taken to reduce the incidence of adverse pregnancy outcomes.