Kaduskar Prashant Ulhas, Dharmalingam Mala, Kalra Pramila
Department of Endocrinology, M.S. Ramaiah Medical College, Bengaluru, Karnataka, India.
Indian J Endocrinol Metab. 2017 Sep-Oct;21(5):660-664. doi: 10.4103/ijem.IJEM_158_17.
Hypothyroidism managed inadequately in pregnancy may have grave outcomes for both mother and baby. Understanding pregnancy outcomes in our country with low awareness about thyroid diseases is important.
The objectives of the study were to evaluate demographic features and biochemical parameters in patients with prepregnancy hypothyroidism versus patients diagnosed to have primary hypothyroidism during pregnancy and to assess pregnancy outcomes.
Prospective design.
The study was conducted in a tertiary care center in Bengaluru for 2 years. The patients were divided into two groups - Group I: Prepregnancy hypothyroidism and Group II: Hypothyroid during pregnancy. They were further staged according to ESI guidelines as subclinical or overt hypothyroidism.
Chi-square and Mann-Whitney test.
A total of 452 pregnant women with hypothyroidism were analyzed. The data of 371 delivered pregnancies were available. Group I and II had 196 (43.36%) and 256 (56.64%) patients, respectively. Age at presentation (years) was 27.09 ± 4.19 in Group I versus 25.74 ± 4.29 in Group II ( = 0.003); gestational age (weeks) was 9.04 ± 5.41 in Group I versus 13.81 ± 9.12 in Group II ( = 0.000). There was one case of congenital hypothyroidism in baby in each group. Mean birth weight was 2.90 ± 0.39 kg in Group I versus 2.88 ± 0.36 kg in Group II; = 0.608. There were four abortions in Group I versus ten in Group II ( = 0.231), 104 cesarean sections in Group I compared to 133 in Group II; ( = 0.382). There was no difference in number of cesarean sections, abortions and low birth weight babies between overt and subclinical hypothyroidism subgroups.
Group I patients presented earlier for testing suggesting awareness was good in this group. There was no difference in pregnancy outcome between the two groups. Overt versus subclinical status did not have any different effects on pregnancy outcomes in any group.
孕期甲状腺功能减退症若管理不当，可能对母婴均造成严重后果。了解我国甲状腺疾病知晓率较低情况下的妊娠结局具有重要意义。
本研究的目的是评估孕前甲状腺功能减退症患者与孕期诊断为原发性甲状腺功能减退症患者的人口统计学特征和生化参数，并评估妊娠结局。
前瞻性设计。
本研究在班加罗尔的一家三级医疗中心进行，为期2年。患者分为两组——第一组：孕前甲状腺功能减退症；第二组：孕期甲状腺功能减退症。根据ESI指南，将其进一步分为亚临床或显性甲状腺功能减退症。
卡方检验和曼-惠特尼检验。
共分析了452例甲状腺功能减退症孕妇。有371例分娩妊娠的数据可供使用。第一组和第二组分别有196例（43.36%）和256例（56.64%）患者。第一组就诊时的年龄（岁）为27.09±4.19，第二组为25.74±4.29（P = 0.003）；第一组的孕周（周）为9.04±5.41，第二组为13.81±9.12（P = 0.000）。每组各有1例婴儿患先天性甲状腺功能减退症。第一组的平均出生体重为2.90±0.39千克，第二组为2.88±0.36千克；P = 0.608。第一组有4例流产，第二组有10例（P = 0.231），第一组有104例剖宫产，第二组有133例；（P = 0.382）。显性和亚临床甲状腺功能减退症亚组之间的剖宫产、流产和低出生体重儿数量没有差异。
第一组患者更早进行检测，表明该组患者的知晓情况良好。两组之间的妊娠结局没有差异。显性与亚临床状态对任何一组的妊娠结局均无不同影响。
