Department for Endemic Disease Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, China.
Postoperation Monitoring Ward, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
J Trace Elem Med Biol. 2018 May;47:104-110. doi: 10.1016/j.jtemb.2018.01.013. Epub 2018 Feb 2.
The study aimed to explore the effects of maternal iodine status and thyroid diseases on adverse pregnancy outcomes.
A prospective study was conducted on 2347 pregnant women, who provided 2347 urinary samples tested for iodine, 1082 serum samples tested for thyroid function, and 2347 questionnaires about demographic information. Their pregnancy outcomes were recorded and compared between different urinary iodine concentration (UIC) and thyroid function groups.
Pregnant women with UIC between 150 and 249 μg/L had lower incidences of preeclampsia (adjusted odds ratio (OR) 0.12, 95% CI: 0.01-0.87), placenta previa (adjusted OR 0.06, 95% CI: 0.01-0.69) and fetal distress (adjusted OR 0.10, 95% CI: 0.02-0.64) than the reference group (UIC < 50 μg/L). Women with UIC between 100 and 149 μg/L had lower risks of abnormal amniotic fluid (adjusted OR 0.32, 95% CI: 0.12-0.87) and fetal distress (adjusted OR 0.08, 95% CI: 0.01-0.82). Women with UIC above 249 μg/L had a significant higher rate of abnormal amniotic fluid (adjusted OR 0.38, 95% CI: 0.16-0.89). Clinical and subclinical hypothyroidism during pregnancy increased the risk of preterm delivery by 4.4 times (P = 0.009) and 3.0 times (P = 0.014), respectively. Isolated hypothyroxinemia had increased odds of having macrosomia (adjusted OR 2.22, 95% CI: 1.13-4.85). Clinical hyperthyroidism was significantly associated with miscarriage (adjusted OR 2.12, 95% CI: 1.92-96.67) and fetal distress (adjusted OR 9.53, 95% CI: 1.05--81.81). Subclinical hyperthyroidism had a significant association with umbilical cord entanglement (adjusted OR 3.82, 95% CI: 1.38-10.58). Isolated hyperthyroxinemia was associated with preterm delivery (adjusted OR 4.73, 95% CI: 1.49-15.05).
Maternal iodine status and thyroid diseases during pregnancy were associated with adverse pregnancy outcomes.
本研究旨在探讨母体碘状况和甲状腺疾病对不良妊娠结局的影响。
对 2347 名孕妇进行前瞻性研究，这些孕妇提供了 2347 份尿液样本进行碘检测，1082 份血清样本进行甲状腺功能检测，以及 2347 份关于人口统计学信息的问卷。记录并比较了不同尿碘浓度（UIC）和甲状腺功能组的妊娠结局。
UIC 在 150 至 249μg/L 之间的孕妇子痫前期（调整后的优势比（OR）0.12，95%CI：0.01-0.87）、前置胎盘（调整后的 OR 0.06，95%CI：0.01-0.69）和胎儿窘迫（调整后的 OR 0.10，95%CI：0.02-0.64）的发生率低于参考组（UIC<50μg/L）。UIC 在 100 至 149μg/L 之间的孕妇羊水异常（调整后的 OR 0.32，95%CI：0.12-0.87）和胎儿窘迫（调整后的 OR 0.08，95%CI：0.01-0.82）的风险较低。UIC 超过 249μg/L 的孕妇羊水异常的发生率显著升高（调整后的 OR 0.38，95%CI：0.16-0.89）。妊娠期间的临床和亚临床甲状腺功能减退症使早产的风险分别增加了 4.4 倍（P=0.009）和 3.0 倍（P=0.014）。单纯甲状腺素血症使巨大儿的发生几率增加（调整后的 OR 2.22，95%CI：1.13-4.85）。临床甲状腺功能亢进症与流产（调整后的 OR 2.12，95%CI：1.92-96.67）和胎儿窘迫（调整后的 OR 9.53，95%CI：1.05-81.81）显著相关。亚临床甲状腺功能亢进症与脐带缠绕显著相关（调整后的 OR 3.82，95%CI：1.38-10.58）。单纯甲状腺素血症与早产有关（调整后的 OR 4.73，95%CI：1.49-15.05）。
妊娠期间母体碘状况和甲状腺疾病与不良妊娠结局有关。
