孕早期亚临床甲状腺功能减退与流产发生的相关性

目的:探讨孕早期亚临床甲状腺功能减退与流产发生的相关性。方法:2017年2月至2019年选择在本院进行建档的孕早期孕妇120例,检测血清游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)、促甲状腺激素(thyroid stimulating hormone,TSH)含量,判断亚甲减发生情况。调查所有孕妇的流产等妊娠结局情况并分析相关性。结果:在120例孕妇中,发生亚甲减18例(亚甲减组),发生率为15.0%。亚甲减组的年龄、孕周、孕次、产次、心率、收缩压、舒张压等指标与非亚甲减组对比差异无统计学意义(P>0.05)。亚甲减组的血清TSH含量高于非亚甲减组,FT3值低于非亚甲减组(P<0.05),两组FT4值对比差异无统计学意义(P>0.05)。亚甲减组的流产发生率为38.9%,显著高于非亚甲减组的2.9%(P<0.05)。亚甲减组的早产、前置胎盘、胎膜早破、产后出血、巨大儿、低体重儿、新生儿窒息等发生率也显著高于非亚甲减组(P<0.05)。在120例孕妇中,Pearson相关分析法显示流产与亚甲减、血清TSH、FT3值都存在相关性(P<0.05)。结论:孕早期亚甲减在临床上比较常见,可导致流产发生率增加,也可增加妊娠不良结局的发生几率,亚甲减与流产存在正向相关性。

Correlation between Subclinical Hypothyroidism in Early Pregnancy and Abortion

ABSTRACT Objective: To explore the correlation between subclinical hypothyroidism and miscarriage in early pregnancy. Methods: From February 2017 to 2019, 120 cases of pregnant women in early pregnancy who chose to file in our hospital were selected as the research objects. The serum free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (thyroid stimulating hormone (TSH) were detected, and were to determine the occurrence of hypothyroidism. And the pregnancy outcomes such as abortion in all pregnant women were record and were given correlation analysis. Results: There were 18 cases of hypoparathyroidism occurred (subparathyroidism group) in the 120 cases, and the incidence rates were 15.0 %. There were no significant differences in age, gestational week, gestation period, parity, heart rate, systolic blood pressure, and diastolic blood pressure compared between the subparathyroidism group and the non-subparathyroidism group (P>0.05). The serum TSH levels in the subparathyroidism group were higher than that in the non-subparathyroidism group, and the FT3 value were lower than that in the non-subparathyroidism group that compared were statistically significant difference(P<0.05). There were no significant difference in the FT4 value compared between the two groups (P>0.05). The incidence rates of miscarriage in the hypomethylene group were 38.9 %, which were significantly higher than that in the non-subparathyroidism group (2.9 %)(P<0.05). The prevalence of preterm birth, placenta previa, premature rupture of membranes, postpartum hemorrhage, gigantic infants, low birth weight infants, neonatal asphyxia, etc. were also significantly higher in the hypomethylated group than in the non-subparathyroidism group(P<0.05). In the 120 pregnant women, Pearson correlation analysis showed that there were correlation between abortion and hypothyroidism, serum TSH, and FT3 values(P<0.05). Conclusion: Hypothyroidism in the early pregnancy are more common clinically, which can lead increase in the incidence of miscarriage and increase the incidence of adverse pregnancy outcomes. There are positive correlation between hypothyroidism and abortion.