Konar Hiralal, Sarkar Madhutandra, Roy Manas
1Department of Obstetrics and Gynecology, Calcutta National Medical College and Hospital, Kolkata, West Bengal India.
2Department of Community Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh India.
J Obstet Gynaecol India. 2018 Aug;68(4):283-288. doi: 10.1007/s13224-017-1033-0. Epub 2017 Jul 25.
This study was undertaken to find out the proportion of women with thyroid dysfunction in pregnancy complicated by diabetes mellitus; to find out the association, if any, of thyroid dysfunction and of antithyroid peroxidase (anti-TPO) antibodies during pregnancy in women with pregestational (PGDM) and gestational diabetes mellitus (GDM); and to find out the maternal and perinatal outcomes of pregnancies complicated by both diabetes mellitus and thyroid dysfunction.
A cross-sectional observational study was conducted in a tertiary care teaching hospital in Kolkata, India, for a period of 1 year. Sixty-four pregnant women with diabetes, both PGDM and GDM, were recruited from the antenatal clinic. They were managed and followed up till 6 weeks postpartum. Their plasma glucose levels were estimated, and thyroid function was evaluated periodically. All relevant data were recorded and analyzed statistically.
Most (81.25%) women had GDM. Forty percent women suffered from some form of thyroid disorder, mostly (37.5%) hypothyroidism. Thyroid dysfunction was not associated with the type of diabetes mellitus (GDM or PGDM) ( > 0.05). The higher rate of anti-TPO titers was observed in pregnancies with PGDM compared to pregnancies with GDM; however, this difference was not statistically associated ( > 0.05). All pregnant women with combined endocrinopathy delivered by cesarean section, and the most common neonatal complication observed was jaundice.
Thyroid disorders are quite common during pregnancy complicated by diabetes mellitus. The study findings warrant routine screening for thyroid abnormalities in diabetic pregnant women. These women have increased rate of maternal and neonatal complications.
本研究旨在确定妊娠合并糖尿病妇女中甲状腺功能障碍的比例;找出孕前糖尿病(PGDM)和妊娠期糖尿病(GDM)妇女孕期甲状腺功能障碍及抗甲状腺过氧化物酶(抗-TPO)抗体之间是否存在关联;并找出合并糖尿病和甲状腺功能障碍的妊娠的母体和围产期结局。
在印度加尔各答的一家三级护理教学医院进行了为期1年的横断面观察性研究。从产前诊所招募了64名患有糖尿病的孕妇,包括PGDM和GDM。对她们进行管理并随访至产后6周。定期评估她们的血糖水平,并评估甲状腺功能。记录所有相关数据并进行统计学分析。
大多数(81.25%)妇女患有GDM。40%的妇女患有某种形式的甲状腺疾病,大多数(37.5%)为甲状腺功能减退。甲状腺功能障碍与糖尿病类型(GDM或PGDM)无关(P>0.05)。与GDM妊娠相比,PGDM妊娠中抗-TPO滴度较高;然而,这种差异无统计学关联(P>0.05)。所有合并内分泌疾病的孕妇均行剖宫产分娩,观察到最常见的新生儿并发症是黄疸。
甲状腺疾病在妊娠合并糖尿病期间相当常见。研究结果表明应对糖尿病孕妇进行甲状腺异常的常规筛查。这些妇女的母体和新生儿并发症发生率增加。