摘要
目的探讨早期妊娠单纯甲状腺过氧化物酶抗体(TPOAb)阳性对早期先兆流产、早期流产等妊娠并发症及不良妊娠结局的影响。方法回顾性选择2017-2019年在该院行TPOAb、促甲状腺激素、血清游离四碘甲状腺原氨酸筛查,且甲状腺功能正常的早期妊娠孕妇25453例,根据TPOAb检测结果将孕妇分为TPOAb阴性组(23478例)及TPOAb阳性组(1975例),比较2组孕妇早期先兆流产及早期流产的发生率。追踪2组孕妇孕期情况,选取在该院规律产检,整个孕期甲状腺功能正常,未使用甲状腺激素等药物,并于该院分娩的孕妇,比较2组孕妇的妊娠并发症及不良妊娠结局发生情况。结果TPOAb阳性组早期先兆流产、早期流产及胎膜早破发生率均高于TPOAb阴性组(P<0.05),而2组妊娠期糖尿病、妊娠期高血压、妊娠期胆汁淤积、胎儿生长受限、胎儿窘迫、早产、羊水异常的发生率比较,差异均无统计学意义(P>0.05)。结论早期妊娠单纯TPOAb阳性可增加早期先兆流产、早期流产及胎膜早破的发生率,应注重早期妊娠甲状腺功能及TPOAb的筛查,对甲状腺功能正常但TPOAb阳性的孕妇应密切关注其甲状腺功能,以减少不良妊娠结局的发生。
Objective To investigate the effect of positive thyroid peroxidase antibodies(TPOAb)in early pregnancy on early threatened abortion,early abortion and other pregnancy complications and adverse pregnancy outcomes.Methods A retrospective selection of 25453 pregnant women in early pregnancy with TPOAb,thyroid stimulating hormone and serum free tetraiodothyronine in the hospital from 2017 to 2019 and normal thyroid function were selected.According to the results of the TPOAb test,the pregnant women were divided into the TPOAb negative group(23478 cases)and the TPOAb positive group(1975 cases),the incidence of early threatened abortion and early abortion was compared between the two groups.The wo groups of pregnant women were followed up during pregnancy,The pregnant women who had regular prenatal examination in ther hospital and had normal thyroid function during the whole pregnancy without using thyroid hormone and other drugs and delivered in our hospital were selected.The pregnancy complications and adverse pregnancy outcomes of two groups of pregnant women were compared.Results The incidences of early threatened abortion,early abortion and premature rupture of membranes in the TPOAb positive group were higher than those in the TPOAb negative group(P<0.05),but there was no statistically significant difference in the incidence of gestational diabetes,gastational hypertention,gestational cholestasis,fetal growth restriction,fetal distress,premature birth and abnormal amniotic fluid between the two groups(P>0.05).Conclusion Simple TPOAb positive in early pregnancy can increase the incidence of early threatened abortion,early abortion and premature rupture of membranes.Early pregnancy thyroid function and TPOAb screening should be paid attention to.Pregnant women with normal thyroid function but TPOAb positive should be paid close attention to their thyroid function,so as to reduce the occurrence of adverse pregnancy outcomes.
作者
余青
谭汝宏
韦僖雯
陈珮琪
林汉杰
李相新
YU Qing;TAN Ruhong;WEI Xiwen;CHEN Peiqi;LIN Hanjie;LI Xiangxin(Department of Clinical Laboratory,the Affiliated Foshan Women and Children Hospital of Southern Medical University,Foshan,Guangdong 528000,China)
出处
《国际检验医学杂志》
CAS
2021年第11期1346-1348,1352,共4页
International Journal of Laboratory Medicine
基金
佛山市科技局医学类科技攻关项目(1920001000245)
广东省基础与应用基础研究基金项目(2019A1515110044)。
关键词
抗甲状腺过氧化物酶抗体
妊娠结局
妊娠并发症
先兆流产
流产
thyroid peroxidase antibody
pregnancy outcomes
pregnancy complications
threatened abortion
abortion
