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目的探讨孕20周前母体亚临床甲状腺功能减退(亚甲减)对妊娠结局的影响。方法以2008年10月-2010年10月在马鞍山市妇幼保健院做产检并签订知情同意书的妇女为研究对象。本课题组成员自行设计调查问卷,收集孕妇的人口统计学特征、孕产史和妊娠结局。由妇幼保健院检验科医师采集研究对象静脉血5 mL,用差速离心法及时分离出血清并保存,用化学发光免疫分析法对孕妇血清进行甲状腺功能检测。利用Logistic回归模型分析孕20周前母体亚甲减与不良妊娠结局的关系。结果采用多因素Logistic回归发现,孕20周前患亚甲减可使孕妇发生早产和胎儿窘迫的风险升高(OR=3.31,95%CI:1.22～8.97;OR=3.54,95%CI:1.41～8.92)。在调整了孕妇的年龄、体质量指数(BMI)和怀孕次数等混杂因素后,亚甲减仍然是孕妇发生早产(OR=3.14,95%CI:1.15～8.57)和胎儿窘迫(OR=3.44,95%CI:1.35～8.78)的危险因素。结论孕20周前妇女患亚甲减是导致不良妊娠结局的重要因素。
Objective To investigate the effect of subclinical hypothyroidism (maternal hypothyroidism) on the outcome of pregnancy before pregnancy 20 weeks. Methods From October 2008 to October 2010 in Ma’anshan Maternal and Child Health Hospital, do the production examination and signed informed consent of the women as the research object. The members of the group designed their own questionnaires to collect the demographic characteristics of pregnant women, the history of pregnancy and pregnancy outcomes. The maternal and child health laboratory test subjects collected venous blood 5 mL, differential centrifugation and timely separation of serum and chemiluminescence immunoassay for serum thyroid function tests. Logistic regression model was used to analyze the relationship between maternal hypothyroidism and adverse pregnancy outcomes before 20 weeks gestation. Results Multivariate logistic regression showed that the risk of preterm birth and fetal distress increased with maternal hypothyroidism 20 weeks before pregnancy (OR = 3.31, 95% CI: 1.22-8.97; OR = 3.54, 95% CI: 1.41 ~ 8.92). Metarrhea was still a premature birth in pregnant women (OR = 3.14, 95% CI: 1.15-8.57) and fetal distress (OR = 3.44, 95% CI: 1.35 ~ 8.78) risk factors. Conclusions 20% of pregnant women suffered from hypothyroidism before pregnancy is an important factor leading to adverse pregnancy outcomes.