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甲状腺癌幸存者的产科结局:一项回顾性队列研究。

Obstetric outcomes in thyroid cancer survivors: A retrospective cohort study.

机构信息

Reproductive Medical Center, Peking University Third Hospital, Beijing, China.

Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

出版信息

Int J Gynaecol Obstet. 2021 Oct;155(1):119-124. doi: 10.1002/ijgo.13571. Epub 2021 Jan 27.

Abstract

OBJECTIVE

To investigate whether thyroid cancer survivors would have increased risks of adverse obstetric outcomes.

METHODS

Data from 154 women with a history of thyroid cancer who had a live birth at Peking University Third Hospital from January 2012 to December 2019 were collected. The control group consisted of 308 women without any thyroid disease or malignant tumor. Age and year of delivery were matched between the two groups.

RESULTS

Serum levels of thyroid stimulating hormone and free thyroxine were significantly lower and higher in thyroid cancer patients, respectively (P < 0.001). After adjusting for age, pre-pregnancy body mass index, pre-pregnancy hypertension, pre-pregnancy diabetes mellitus, previous cesarean section, and conception by in vitro fertilization/intracytoplasmic injection, adverse obstetric outcomes including preterm birth (odds ratio [OR] 0.73, 95% confidence interval [CI] 0.32-1.67), low birth weight infant (OR 1.05, 95% CI 0.44-2.50), gestational diabetes mellitus (OR 0.86, 95% CI 0.54-1.39), and pre-eclampsia (OR 1.11, 95% CI 0.34-3.57) showed no differences between thyroid cancer survivors and the control group. However, pregnant women with a history of thyroid cancer had a higher risk of abnormally invasive placentation (OR 10.57, 95% CI 1.22-91.97, P = 0.032).

CONCLUSION

Although the thyroid function status of thyroid cancer patients was different from that of pregnant women without any thyroid disease or malignancy, they would not be at a higher risk of most adverse obstetric outcomes except for abnormally invasive placentation.

摘要

目的

探讨甲状腺癌幸存者是否具有不良产科结局的风险增加。

方法

收集了 2012 年 1 月至 2019 年 12 月在北京大学第三医院分娩的 154 例甲状腺癌存活患者的数据。对照组由 308 名无甲状腺疾病或恶性肿瘤的女性组成。两组之间匹配了年龄和分娩年份。

结果

甲状腺癌患者的血清促甲状腺激素和游离甲状腺素水平显著较低和较高(P<0.001)。在校正年龄、孕前体重指数、孕前高血压、孕前糖尿病、既往剖宫产术和体外受精/卵胞浆内注射受孕后,不良产科结局包括早产(比值比[OR] 0.73,95%置信区间[CI] 0.32-1.67)、低出生体重儿(OR 1.05,95%CI 0.44-2.50)、妊娠期糖尿病(OR 0.86,95%CI 0.54-1.39)和子痫前期(OR 1.11,95%CI 0.34-3.57)在甲状腺癌幸存者和对照组之间无差异。然而,有甲状腺癌病史的孕妇异常侵袭性胎盘的风险更高(OR 10.57,95%CI 1.22-91.97,P=0.032)。

结论

尽管甲状腺癌患者的甲状腺功能状态与无甲状腺疾病或恶性肿瘤的孕妇不同,但除异常侵袭性胎盘外,她们大多数不良产科结局的风险并不增加。

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