既往诊断为亚临床甲状腺功能减退症的女性的后续妊娠结局。
Subsequent pregnancy outcomes in women previously diagnosed with subclinical hypothyroidism.
机构信息
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, Texas.
出版信息
Am J Perinatol. 2014 Jan;31(1):77-84. doi: 10.1055/s-0033-1334457. Epub 2013 Mar 1.
OBJECTIVE
To evaluate subsequent pregnancy outcomes in women previously identified during an index pregnancy to have subclinical hypothyroidism (SCH).
STUDY DESIGN
From 2000 to 2003, thyroid analytes were measured in 17,298 women. Using their index pregnancy thyroid-analyte classification, pregnancy outcomes were compared between the returning cohorts.
RESULTS
There were 6,985 women previously screened and subsequently delivered at our hospital though 2011 with 230 (3.3%) designated to have SCH and 6,645 (95.1%) euthyroid. Significant differences between the two cohorts included risk for diabetes (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.2 to 2.7, p = 0.005), gestational diabetes (OR 1.74, 95% CI 1.13 to 2.69, p = 0.015), and stillbirth (OR 3.5, 95% CI 1.05 to 11.68, p = 0.042). After adjustment, the increased likelihood of diabetes (adjusted OR 1.58, 95% CI 1.04 to 2.40, p = 0.032) and stillbirth (adjusted OR 3.41, 95% CI 1.01 to 11.49, p = 0.048) persisted.
CONCLUSIONS
Women identified during a previous pregnancy with SCH are at increased risk for some adverse perinatal outcomes during a subsequent pregnancy.
目的
评估先前在指数妊娠期间被诊断为亚临床甲状腺功能减退症（SCH）的女性的后续妊娠结局。
研究设计
2000 年至 2003 年，对 17298 名女性进行了甲状腺分析物测量。根据她们的指数妊娠甲状腺分析物分类，比较了返回队列之间的妊娠结局。
结果
在我们医院，有 6985 名妇女先前接受了筛查，随后在 2011 年分娩，其中 230 名（3.3%）被指定为 SCH，6645 名（95.1%）为甲状腺功能正常。两个队列之间存在显著差异，包括糖尿病风险（优势比[OR]1.8，95%置信区间[CI]1.2 至 2.7，p=0.005）、妊娠期糖尿病（OR 1.74，95%CI 1.13 至 2.69，p=0.015）和死产（OR 3.5，95%CI 1.05 至 11.68，p=0.042）。调整后，糖尿病（调整后 OR 1.58，95%CI 1.04 至 2.40，p=0.032）和死产（调整后 OR 3.41，95%CI 1.01 至 11.49，p=0.048）的可能性仍增加。
结论
在先前的妊娠中被诊断为 SCH 的女性在随后的妊娠中发生某些不良围产期结局的风险增加。
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