Ma Liangkun, Qi Hong, Chai Xiaofeng, Jiang Fang, Mao Su, Liu Juntao, Zhang Shaoqin, Lian Xiaolan, Sun Xiujing, Wang Danhua, Ren Jie, Yan Qi
a Department of Obstetrics and Gynecology , Peking Union Medical College Hospital , Beijing , China .
b Prenatal Screening Center, Department of Obstetrics and Gynecology, Haidian Maternal & Child Health Hospital , Beijing , China .
J Matern Fetal Neonatal Med. 2016;29(9):1391-4. doi: 10.3109/14767058.2015.1049150. Epub 2015 Jul 16.
To evaluate the effect of subclinical hypothyroidism (SCH) screening and intervention on pregnancy outcomes and explore the significance of thyroid function during early pregnancy.
Pregnant women were recruited from Peking Union Medical College Hospital (screening group for measuring thyroid function and thyroid antibody in early pregnancy) and Haidian Maternal & Child Health Hospital (control group whose serum was stored and measured shortly after delivery) from July 2011 to December 2012. Thyrotropin levels 2.5-10 mIU/L and free T4 levels in normal range were considered SCH. Some of the screening group were treated with levothyroxine and adjusted. The others did not take medicine but kept a regular follow-up visit to doctors after antenatal clinic. The pregnancy outcomes and complications were compared.
1671 women (675 in screening group and 996 in control group) were recruited. 419 (167 from screening group) women was diagnosed as SCH. In screening group, 105 SCH and 4 hypothyroid women received thyroid hormone replacement therapy. The miscarriage and fetal macrosomia risks were lower, and cesarean was higher in screening group than control.
Screening and intervention of SCH can significantly reduce the incidence rate of miscarriage.
评估亚临床甲状腺功能减退症（SCH）筛查及干预对妊娠结局的影响，并探讨孕早期甲状腺功能的意义。
选取2011年7月至2012年12月在北京协和医院（孕早期测量甲状腺功能及甲状腺抗体的筛查组）和海淀区妇幼保健院（产后即刻储存并检测血清的对照组）就诊的孕妇。促甲状腺激素水平为2.5 - 10 mIU/L且游离T4水平在正常范围者被视为SCH。筛查组部分患者接受左甲状腺素治疗并进行调整。其余患者未服药，但在产前检查后定期复诊。比较两组的妊娠结局及并发症。
共纳入1671名女性（筛查组675名，对照组996名）。419名女性（筛查组167名）被诊断为SCH。筛查组中，105名SCH患者和4名甲状腺功能减退患者接受了甲状腺激素替代治疗。筛查组的流产和巨大儿风险较低，剖宫产率高于对照组。
SCH的筛查及干预可显著降低流产发生率。
