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目的探讨妊娠期甲状腺功能减退症与妊娠期高血压疾病的关系及对母婴结局的影响。方法选择2013年7月-2016年3月天津医科大学第二医院收治的180例孕妇为研究对象,根据是否合并甲状腺功能减退,将其分为观察组和对照组,其中观察组91例,为甲状腺功能减退孕妇;对照组89例,为甲状腺功能正常孕妇。检测两组孕妇血清甲状腺激素(FT_4)、三碘甲状腺原氨酸(FT_3)及促甲状腺激素(TSH),观察两组孕妇妊娠期间妊娠高血压发生情况,及其对孕妇妊娠结局及胎儿的影响。结果观察组孕妇FT_3、FT_4水平显著低于对照组(P<0.05),TSH水平显著高于对照组(P<0.05);观察组妊娠期高血压发生率为10.99%,对照组为2.25%,两组比较,差异有统计学意义(χ~2=5.526;P=0.019);观察组胎膜早破、早产、产后出血、新生儿黄疸、新生儿呼吸窘迫综合征及窒息的发生率均高于对照组(均P<0.05)。结论妊娠期孕妇甲状腺功能减退会增加其妊娠高血压的发生率,且可增加孕妇胎膜早破、早产及产后出血,增加新生儿黄疸、新生儿呼吸窘迫综合征及窒息的发生。
Objective To investigate the relationship between hypothyroidism during pregnancy and hypertensive disorder complicating pregnancy and its effect on maternal and infant outcomes. Methods From July 2013 to March 2016, 180 pregnant women admitted to the Second Hospital of Tianjin Medical University were selected as study subjects. According to whether they had hypothyroidism or not, they were divided into observation group and control group. The observation group included 91 cases Hypothyroidism in pregnant women; control group of 89 patients with normal thyroid function in pregnant women. The levels of serum thyroid hormone (FT_4), triiodothyronine (FT_3) and thyroid stimulating hormone (TSH) were detected in two groups of pregnant women. The incidence of pregnancy-induced hypertension during pregnancy was observed in both groups, and their effects on pregnancy outcome and fetus . Results The levels of FT_3 and FT_4 in pregnant women in observation group were significantly lower than those in control group (P <0.05), while the levels of TSH in observation group were significantly higher than those in control group (P <0.05). The incidence of gestational hypertension was 10.99% in observation group, 2.25% The differences between the two groups were statistically significant (χ ~ 2 = 5.526; P = 0.019). The incidences of premature rupture of membranes, premature labor, postpartum hemorrhage, neonatal jaundice, neonatal respiratory distress syndrome and asphyxia in observation group were all high In the control group (all P <0.05). Conclusions Pregnant women with hypothyroidism during pregnancy may increase their incidence of pregnancy-induced hypertension and may increase premature rupture of membranes, premature labor and postpartum hemorrhage, neonatal jaundice, neonatal respiratory distress syndrome and asphyxia.