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目的探讨舟山地区妊娠妇女的孕期各阶段甲状腺激素的影响因素。方法选取孕妇358名,检测其孕早期、孕中期、孕晚期血清甲状腺激素,并对其进行问卷调查,用logistic回归模型分析甲状腺素异常的影响因素。结果早、中、晚孕阶段分别发现甲状腺异常孕妇116、104、81例。早孕阶段孕妇甲状腺素异常的危险因素分别是孕前吸烟(OR=11.212,95%CI:5.965~19.232))、孕前饮酒(OR=2.151,95%CI:1.132~5.131)、孕前丈夫吸烟(OR=3.555,95%CI:2.216~6.325)、孕期中丈夫吸烟(OR=4.151,95%CI:1.350~8.254)、中度抑郁(OR=3.588,95%CI:1.059~7.233)、中度焦虑(OR=4.566,95%CI:2.128~8.612)(P<0.05);中孕阶段孕妇甲状腺素异常的危险因素分别是孕前吸烟(OR=4.123,95%CI:3.313~5.489)、孕前丈夫吸烟(OR=3.512,95%CI:1.247~6.220)、轻度焦虑(OR=5.335,95%CI:3.254~9.363)、中度焦虑(OR=7.151,95%CI:4.259~12.362)(P<0.05);晚孕阶段孕妇甲状腺素异常的危险因素分别是孕前吸烟(OR=2.251,95%CI:1.741~3.369)、轻度抑郁(OR=4.251,95%CI:2.699~7.984)、中度抑郁(OR=5.714,95%CI:2.364~10.284)、轻度焦虑(OR=7.596,95%CI:2.636~13.585)、中度焦虑(OR=5.151,95%CI:1.154~9.541)(P<0.05)。结论孕妇和丈夫戒烟、缓解抑郁和焦虑的情绪,有助于防范和减少舟山本地区孕妇妊娠期甲状腺疾病。
Objective To investigate the influencing factors of thyroid hormones in pregnant women in Zhoushan during different stages of pregnancy. Methods A total of 358 pregnant women were selected for detection of serum thyroid hormones during the first trimester, second trimester and third trimester of pregnancy. A questionnaire survey was conducted to investigate the influencing factors of thyroid hormone abnormality by logistic regression model. Results Early, middle and late stages of pregnancy were found abnormal thyroid 116,104,81 pregnant women. The risk factors for thyroid hormone abnormalities in the first trimester were pre-pregnancy smoking (OR = 11.212, 95% CI: 5.965-19.232), pre-pregnancy drinking (OR = 2.151, 95% CI: 1.132-5.131) (OR = 4.151, 95% CI: 1.350-8.254), moderate depression (OR = 3.588, 95% CI: 1.059-7.233), moderate anxiety OR = 4.566,95% CI: 2.128-8.612) (P <0.05). The risk factors for thyroid hormone abnormalities during the second trimester were pre-pregnancy smoking (OR = 4.123, 95% CI: 3.313-5.489) OR = 3.512, 95% CI: 1.247-6.220), mild anxiety (OR = 5.335,95% CI: 3.254-9.363), moderate anxiety (OR = 7.151,95% CI: 4.259-12.362) (OR = 2.251, 95% CI: 1.741-3.369), mild depression (OR = 4.251, 95% CI: 2.699-7.984), moderate depression (OR = 5.714, 95% CI: 2.364-10.284), mild anxiety (OR = 7.596, 95% CI: 2.636-13.585), moderate anxiety (OR = 5.151, 95% CI: 1.154-9.541) 0.05). Conclusions Both pregnant women and their husband quit smoking and relieve depression and anxiety, which helps to prevent and reduce the thyroid disease in pregnant women in Zhoushan.