肥胖合并甲状腺功能减退的孕妇的妊娠结局：沙特阿拉伯一家三级中心的病历回顾

Pregnancy Outcomes among Obese Pregnant Women with Hypothyroidism: Medical Record Review of a Single Tertiary Center in Saudi Arabia.

作者信息

Fallatah Anas M, Hasanain Anhar, Babatin Hussam, Nassibi Khalid M, Thigah Samaher, Abduljabbar Hassan S

机构信息

Medicine, King Abdulaziz University, Jeddah, SAU.

Obstetrics and Gynecology, King Abdulaziz University, Jeddah, SAU.

出版信息

Cureus. 2020 Feb 10;12(2):e6938. doi: 10.7759/cureus.6938.

DOI:10.7759/cureus.6938

PMID:32190490

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7067361/

Abstract

Background Thyroid disorder is common among pregnant women. Hashimoto thyroiditis is the most common etiology of hypothyroidism among pregnant women. Many studies showed that hypothyroidism during pregnancy has been associated with negative outcomes for the mother and for child as well including miscarriage, intrauterine growth retardation, preterm delivery and cognitive impairment in the offspring. Objectives To assess the adverse maternal and neonatal outcome among hypothyroidism obese pregnant women. Methods This is a retrospective study conducted among obese pregnant women diagnosed with hypothyroidism attending King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia between January 1, 2013, and December 31, 2018. For analysis, we used (1) descriptive statistics, (2) Chi-square test, Pearson correlation, independent t-test, and one-way ANOVA to test the difference in thyroid stimulating hormone (TSH) levels and adverse pregnancy outcomes. A p-value of <0.05 is used to calculate statistical significance. Results A total of 9095 pregnant women had delivered in the last five years, 65 of these pregnant women had been diagnosed with hypothyroidism and 57 were enrolled in our study. Out of 65, 44 (77.2%) were Saudi, and 13 (22.8%) non-Saudis. Mean age at the time of delivery was 32.9 ± 5.6 years, while BMI means were 35.7 ± 4.6. A total of 35 (61.4%) were from class 1, 14 (26.2%) were from class 2 and eight (12.3%) were from class 3. Out of 57, 16 (28.1%) developed undesired antepartum outcomes, while 14 (21.5%) had postpartum outcomes. Preterm labor, gestational diabetes mellitus, and urinary tract infections were significantly associated with abnormal TSH levels (P < 0.05). Conclusion As demonstrated earlier, hypothyroidism during pregnancy leads to unfavorable outcomes. Therefore, screening for thyroid function tests in prenatal and antenatal periods is vital to avoid potential adverse outcomes.

摘要

背景

甲状腺疾病在孕妇中很常见。桥本甲状腺炎是孕妇甲状腺功能减退最常见的病因。许多研究表明，孕期甲状腺功能减退与母亲和孩子的不良结局有关，包括流产、胎儿宫内生长受限、早产以及后代的认知障碍。

目的

评估甲状腺功能减退的肥胖孕妇的母婴不良结局。

方法

这是一项回顾性研究，研究对象为2013年1月1日至2018年12月31日期间在沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院（KAUH）就诊的诊断为甲状腺功能减退的肥胖孕妇。为了进行分析，我们使用了（1）描述性统计，（2）卡方检验、Pearson相关性分析、独立t检验和单因素方差分析来检验促甲状腺激素（TSH）水平与不良妊娠结局之间的差异。p值<0.05用于计算统计学显著性。

结果

在过去五年中，共有9095名孕妇分娩，其中65名孕妇被诊断为甲状腺功能减退，57名孕妇纳入我们的研究。在这65名孕妇中，44名（77.2%）是沙特人，13名（22.8%）是非沙特人。分娩时的平均年龄为32.9±5.6岁，而体重指数（BMI）平均值为35.7±4.6。共有35名（61.4%）属于1级，14名（26.2%）属于2级，8名（12.3%）属于3级。在57名孕妇中，16名（28.1%）出现了不良的产前结局，14名（21.5%）出现了产后结局。早产、妊娠期糖尿病和尿路感染与TSH水平异常显著相关（P<0.05）。