Aggarawal Neelam, Suri Vanita, Singla Rimpi, Chopra Seema, Sikka Pooja, Shah Viral N, Bhansali Anil
Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Gynecol Obstet Invest. 2014;77(2):94-9. doi: 10.1159/000357615. Epub 2014 Jan 24.
Data comparing pregnancy outcome in hyperthyroid women with euthyroid women are scarce. Hence, this study was carried out to assess the maternal and fetal outcome in pregnant women with hyperthyroidism to ascertain the effect of disease on pregnancy.
This retrospective study was conducted over a period of 28 years. We compared the maternal and fetal outcomes of 208 hyperthyroid women with 403 healthy controls, between women with well-controlled and uncontrolled disease and amongst women diagnosed with hyperthyroidism before and during pregnancy.
Maternal outcome: women with hyperthyroidism were at increased risk for preeclampsia (OR = 3.94), intrauterine growth restriction (OR = 2.16), spontaneous preterm labor (OR = 1.73), preterm birth (OR = 1.7), gestational diabetes mellitus (OR = 1.8), and cesarean delivery (OR = 1.47). Hyperthyroid women required induction of labor more frequently (OR = 3.61). Fetal outcome: newborns of hyperthyroid mothers had lower birth weight than normal ones (p = 0.0001). Women with uncontrolled disease had higher odds for still birth (OR = 8.42; 95% CI: 2.01-35.2) and lower birth weight (p = 0.0001).
Obstetrical complications were higher in women with hyperthyroidism than normal women. Outcome was worsened by uncontrolled disease. Women with pregestational hyperthyroidism had better outcomes than those diagnosed with it during pregnancy.
关于甲亢女性与甲状腺功能正常女性妊娠结局对比的数据较为匮乏。因此,开展本研究以评估甲亢孕妇的母婴结局,从而确定疾病对妊娠的影响。
本回顾性研究历时28年。我们比较了208例甲亢女性与403例健康对照者的母婴结局,比较了疾病控制良好与控制不佳的女性,以及妊娠前和妊娠期诊断为甲亢的女性。
孕产妇结局:甲亢女性发生子痫前期(比值比[OR]=3.94)、胎儿生长受限(OR=2.16)、自发性早产(OR=1.73)、早产(OR=1.7)、妊娠期糖尿病(OR=1.8)及剖宫产(OR=1.47)的风险增加。甲亢女性更频繁需要引产(OR=3.61)。胎儿结局:甲亢母亲的新生儿出生体重低于正常新生儿(p=0.0001)。疾病控制不佳的女性死产几率更高(OR=8.42;95%置信区间:2.01-35.2)且出生体重更低(p=0.0001)。
甲亢女性的产科并发症高于正常女性。疾病控制不佳会使结局恶化。妊娠前患甲亢的女性比妊娠期诊断为甲亢的女性结局更好。