论文部分内容阅读
目的探讨亚临床甲状腺功能减退(Subclinical Hypothyroidism,SCH)合并妊娠期糖尿病(Gestational Diabetes Mellitus,GDM)对妊娠结局的影响。方法选取2014年1月-2014年12月在邢台市人民医院建档,经甲状腺功能筛查诊断为SCH单胎妊娠妇女285例,同期正常单胎妊娠妇女2181例为对照,依据妊娠24~28周行75 g葡萄糖耐量试验(Oral Glucose Tolerance Test OGTT)结果将其分为四组(对照组1909例、SCH组201例、GDM组272例及SCH+GDM组84例),对四组的新生儿体重及妊娠结局进行比较。结果 GDM组新生儿体重大于SCH组(t=2.264,P=0.032)及对照组(t=2.586,P=0.011)。4组在妊娠期高血压(χ2=49.588,P<0.001)、剖宫产(χ2=30.7736,P<0.001)、新生儿窒息(χ2=9.759,P=0.021)、早产流产(χ2=9.240,P=0.026)总体上有显著差异,组间两两比发现SCH+GDM组在妊娠期高血压发病高于GDM组(χ2=11.197,P=0.001)、SCH组(χ2=25.543,P<0.001)及对照组(χ2=41.480,P<0.001);SCH+GDM组在剖宫产比例高于GDM组(χ2=8.902,P=0.003)、SCH组(χ2=12.170,P<0.001)及对照组(χ2=26.989,P<0.001);SCH+GDM组在新生儿窒息高于SCH组(χ2=4.118,P=0.042)、GDM组(χ2=6.464,P=0.031)及对照组(χ2=9.662,P=0.002)。SCH+GDM组在早产、流产高于SCH组(χ2=8.350,P=0.004)、GDM组(χ2=7.044,P=0.008)及对照组(χ2=11.696,P=0.001)。而4组在胎膜早破(χ2=4.939,P=0.176)、胎盘早剥(χ2=7.485,P=0.058)、产后出血(χ2=6.973,P=0.073)发病差异无统计学意义。结论 SCH合并GDM增加妊娠不良结局的风险,应注重SCH妊娠妇女血糖监测及控制。
Objective To investigate the effect of subclinical hypothyroidism (SCH) combined with gestational diabetes (Gestational Diabetes Mellitus) on pregnancy outcome. Methods Selected from January 2014 to December 2014 in Xingtai People’s Hospital, 285 cases of SCH singleton pregnancy diagnosed by thyroid function screening and 2181 cases of normal singleton pregnancy were enrolled in this study. According to pregnancy 24-28 Week Oral Glucose Tolerance Test (OGTT) results were divided into four groups (control group 1909 cases, SCH group 201 cases, GDM group 272 cases and SCH + GDM group 84 cases), the four groups of freshmen Weight and pregnancy outcomes were compared. Results The neonatal weight of GDM group was significantly higher than that of SCH group (t = 2.264, P = 0.032) and control group (t = 2.586, P = 0.011). The incidences of preterm labor (χ2 = 9.240, P <0.001), cesarean section (χ2 = 30.7736, P <0.001) and neonatal asphyxia (χ2 = 9.759, P = 0.026). There was a significant difference between the two groups in SCH group (P <0.001), SCH group (χ2 = 25.543, P <0.001) ) And control group (χ2 = 41.480, P <0.001). The incidence of cesarean section in SCH + GDM group was higher than that in GDM group (χ2 = 8.902, P = 0.003) (Χ2 = 6.494, P = 0.031) and control group (χ2 = 26.989, P <0.001). The incidence of asphyxia in SCH + GDM group was higher than that in SCH group (χ2 = 4.118, 9.662, P = 0.002). SCH + GDM group was higher in preterm labor than in SCH group (χ2 = 8.350, P = 0.004), GDM group (χ2 = 7.044, P = 0.008) and control group (χ2 = 11.696, P = 0.001). There was no significant difference in the incidence of premature rupture of membranes (χ2 = 4.939, P = 0.176), placental abruption (χ2 = 7.485, P = 0.058) and postpartum hemorrhage (χ2 = 6.973, P = 0.073) Conclusions SCH combined with GDM increases the risk of adverse outcomes of pregnancy, and should pay attention to the monitoring and control of blood glucose in SCH pregnant women.