Kumru Pinar, Erdogdu Emre, Arisoy Resul, Demirci Oya, Ozkoral Aysen, Ardic Cem, Ertekin Arif Aktug, Erdogan Sinan, Ozdemir Nilufer Nihan
Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, Istanbul, Turkey.
Arch Gynecol Obstet. 2015 May;291(5):1047-54. doi: 10.1007/s00404-014-3533-9. Epub 2014 Nov 12.
The objective of this study was to assess the effect of thyroid dysfunction and autoimmunity in early pregnancy on adverse pregnancy and neonatal outcome.
497 pregnant women between 10 and 12 gestational age were invited who were attending for their first antenatal visit and asked to perform blood tests for thyroid function and antithyroid peroxidase antibodies. A total of 395 women were recruited in the present study. Cases were classified into four groups according to thyroid function and anti-TPO results. The pregnancy outcomes included gestational diabetes mellitus, preeclampsia, preterm delivery, cesarean rate, small for gestational age, low birth weight.
2.5-(OR 2.5, 95% CI 1.06-5.89) and 4.8-(OR 4.85, 95% CI 1.89-12.42) fold increase in preterm delivery was detected in groups with isolated anti-TPO positivity and subclinic hypothyroidism with anti-TPO positivity compared to reference group, respectively. No association was found between thyroid dysfunction and anti-TPO positivity with gestational diabetes, preeclampsia, cesarean rates, low birth weight and small for gestational age neonates.
Pregnant women with anti-TPO antibody positivity alone or with subclinic hypothyroidism were more likely to experience a spontaneous preterm delivery.
本研究的目的是评估孕早期甲状腺功能障碍和自身免疫对不良妊娠及新生儿结局的影响。
邀请了497名孕龄在10至12周的孕妇,她们前来进行首次产前检查,并要求进行甲状腺功能和抗甲状腺过氧化物酶抗体的血液检测。本研究共招募了395名女性。根据甲状腺功能和抗甲状腺过氧化物酶(anti-TPO)检测结果将病例分为四组。妊娠结局包括妊娠期糖尿病、先兆子痫、早产、剖宫产率、小于胎龄儿、低出生体重。
与参照组相比,单纯抗-TPO阳性组和伴有抗-TPO阳性的亚临床甲状腺功能减退组的早产发生率分别增加了2.5倍(比值比2.5,95%置信区间1.06 - 5.89)和4.8倍(比值比4.85,95%置信区间1.89 - 12.42)。未发现甲状腺功能障碍及抗-TPO阳性与妊娠期糖尿病、先兆子痫、剖宫产率、低出生体重及小于胎龄儿之间存在关联。
单纯抗-TPO抗体阳性或伴有亚临床甲状腺功能减退的孕妇更易发生自发性早产。