Ajmani Sangita Nangia, Aggarwal Deepa, Bhatia Pushpa, Sharma Manisha, Sarabhai Vinita, Paul Mohini
Department of Obstetrics and Gynecology, Kasturba Hospital, New Delhi, 110002 India ; D-117, Ajay Enclave, P.O Tilak Nagar, New Delhi, 110018 India.
Department of Obstetrics and Gynecology, Kasturba Hospital, New Delhi, 110002 India.
J Obstet Gynaecol India. 2014 Apr;64(2):105-10. doi: 10.1007/s13224-013-0487-y. Epub 2013 Dec 1.
To determine the current prevalence of thyroid dysfunction in normal pregnant women and to study the impact of thyroid dysfunction on maternal and fetal outcome.
400 pregnant women between 13 and 26 weeks of gestation were registered for the study. Apart from routine obstetrical investigations, TSH tests were done. Free T4 and anti-TPO antibody tests were done in patients with deranged TSH. Patients were followed up till delivery. Their obstetrical and perinatal outcomes were noted.
The prevalence of hypothyroidism and hyperthyroidism was 12 and 1.25 %, respectively. Adverse maternal effects in overt hypothyroidism included preeclampsia (16.6 vs. 7.8 %) and placental abruption (16.6 vs. 0.8 %). Subclinical hypothyroidism was associated with preeclampsia (22.3 vs. 7.8 %) as compared to the euthyroid patients. Adverse fetal outcomes in overt hypothyroidism included spontaneous abortion (16.6 vs. 2.39 %), preterm birth (33.3 vs. 5.8 %), low birth weight (50 vs. 12.11 %), intrauterine growth retardation (25 vs. 4.9 %), and fetal death (16.6 vs. 1.7 %) as compared to the euthyroid women. Adverse fetal outcomes in subclinical hypothyroidism included spontaneous abortion (5.5 vs. 2.39 %), preterm delivery (11.2 vs. 5.8 %), low birth weight (25 vs. 12.11 %), and intrauterine growth retardation (8.4 vs. 4.9 %) as compared to the euthyroid women.
The prevalence of thyroid disorders was high in our study with associated adverse maternal and fetal outcomes. Routine screening of thyroid dysfunction is recommended to prevent adverse fetal and maternal outcome.
确定正常孕妇甲状腺功能障碍的当前患病率，并研究甲状腺功能障碍对母婴结局的影响。
400名妊娠13至26周的孕妇登记参加本研究。除常规产科检查外，还进行了促甲状腺激素（TSH）检测。TSH异常的患者进行了游离甲状腺素（Free T4）和抗甲状腺过氧化物酶抗体检测。患者随访至分娩。记录其产科和围产期结局。
甲状腺功能减退症和甲状腺功能亢进症的患病率分别为12%和1.25%。显性甲状腺功能减退症的不良母体影响包括先兆子痫（16.6%对7.8%）和胎盘早剥（16.6%对0.8%）。与甲状腺功能正常的患者相比，亚临床甲状腺功能减退症与先兆子痫相关（22.3%对7.8%）。与甲状腺功能正常的女性相比，显性甲状腺功能减退症的不良胎儿结局包括自然流产（16.6%对2.39%）、早产（33.3%对5.8%）、低出生体重（50%对12.11%）、宫内生长受限（25%对4.9%）和胎儿死亡（16.6%对1.7%）。与甲状腺功能正常的女性相比，亚临床甲状腺功能减退症的不良胎儿结局包括自然流产（5.5%对2.39%）、早产（11.2%对5.8%）、低出生体重（25%对12.11%）和宫内生长受限（8.4%对4.9%）。
在我们的研究中，甲状腺疾病的患病率较高，并伴有不良的母婴结局。建议常规筛查甲状腺功能障碍以预防不良的胎儿和母体结局。
