摘要
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 assess the effect of maternal subclinical hypothyroidism before the first twenty weeks on pregnant outcomes. Methods Pregnant women attending antenatal visits at maternal and child health center of Ma＇anshan and providing with informed consent from Oct.2008 to Oct.2010 were recruited into the cohort.The questionnaire was designed by the members of the study and the demographic characteristics,the history of pregnancy and pregnancy outcomes were obtained.Doctor of clinical laboratory in maternal and child health center collected 5 mL blood sample from eligible women,serum was abstracted by different velocity centrifugation method and preserved.Then,serum samples were tested for thyroid hormones by chemiluminescent immunoassays.The relationship between maternal subclinical hypothyroi-dism before the first twenty weeks and adverse pregnant outcomes by Logistic regression model. Results Using non-condition Logistic regression model,it was seen that subclinical hypothyroidism before the first twenty weeks of pregnancy increased the risk of preterm birth and fetal distress [odds ratio（OR）：3.31,95% confidence interval（CI）：1.22-8.97;OR：3.54,95%CI：1.41-8.92].After adjusted confounding factors（such as age,body mass index and parity）,subclinical hypothyroidism before the first twenty weeks of pregnancy was still the risk factor of preterm birth（OR：3.14,95%CI：1.15-8.57） and fetal distress（OR：3.44,95%CI：1.35-8.78）. Conclusion Maternal subclinical hypothyroidism before the first twenty weeks is important factor which can lead to the adverse pregnant outcomes.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2012年第8期574-576,共3页
Journal of Applied Clinical Pediatrics
基金
国家科技支撑计划重大项目(2006BAI05A03)
国家自然科学基金(30901202
30901203)
关键词
甲状腺功能减退
妊娠结局
甲状腺素
胎儿窘迫
早产
hypothyroidism
pregnancy outcome
thyroid hormones
fetal distress
preterm birth
