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孕早期联合筛查结果与促甲状腺激素水平的相关性及其对妊娠结局的影响。

The Correlation between the First Trimester Combined Test Results and Thyroid Stimulating Hormone Levels as Well as Its Effect on Pregnancy Outcomes.

作者信息

Ozsoz Kolsuz Ezgi, Uysal Dilek, Gulbahar Aysegul

机构信息

Department of Obstetrics and Gynecology, Kutahya University of Health Sciences, Evliya Celebi Training and Research Hospital, Kutahya, Turkey.

Department of Obstetrics and Gynecology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.

出版信息

Iran J Public Health. 2023 Apr;52(4):695-702. doi: 10.18502/ijph.v52i4.12437.

Abstract

BACKGROUND

Determining the pregnancy outcomes with independent prognostic factors in the first trimester combined screening test and thyroid stimulating hormone (TSH) is a concern for practitioners. We aimed to evaluate the correlation between TSH and first trimester combined screening test levels and examine their effects on pregnancy outcomes in healthy pregnant women.

METHODS

A total of 349 pregnant women in Izmir Ataturk Training and Research Hospital, Turkey with normal TSH values in the first trimester between 2015 and 2020 were enrolled. Patients were divided into two groups as 274 and 75 patients according to TSH values with 2,5 as cut-off value; their birth weights and weeks were compared. Patients were also divided into three groups according to gestational weeks; their TSH values and combined tests were compared.

RESULTS

When grouped based on the TSH threshold value (2.5uIU/ml), no significant relationship was found between the combined test parameters and TSH levels. In the combined test, after grouping according to the week of gestation, a negative correlation was observed between free beta-human chorionic gonadotropin (β-hCG) and TSH measured at 11 weeks (=0.040, r=-0.189). A significant negative correlation was found between free β-hCG and newborn birth weight (=0.032, r=-0.199), TSH and delivery time (=0.011, r=-0.235).

CONCLUSION

Free β-hCG and TSH levels could guide practitioners for birth weight and early delivery, respectively. Postponing the combined test for patients with elevated serum TSH levels to between the 12th and 13th weeks of gestation may reduce false positives.

摘要

背景

确定孕早期联合筛查试验及促甲状腺激素(TSH)的独立预后因素对妊娠结局的影响是从业者关注的问题。我们旨在评估TSH与孕早期联合筛查试验水平之间的相关性,并研究它们对健康孕妇妊娠结局的影响。

方法

纳入2015年至2020年间在土耳其伊兹密尔阿塔图尔克培训与研究医院孕早期TSH值正常的349名孕妇。根据TSH值以2.5为临界值将患者分为两组,分别为274例和75例;比较她们的出生体重和孕周。患者还根据孕周分为三组;比较她们的TSH值和联合检测结果。

结果

根据TSH阈值(2.5uIU/ml)分组时,联合检测参数与TSH水平之间未发现显著关系。在联合检测中,按孕周分组后,11周时测得的游离β-人绒毛膜促性腺激素(β-hCG)与TSH之间呈负相关(=0.040,r=-0.189)。游离β-hCG与新生儿出生体重之间存在显著负相关(=0.032,r=-0.199),TSH与分娩时间之间存在显著负相关(=0.011,r=-0.235)。

结论

游离β-hCG和TSH水平可分别为从业者预测出生体重和早产提供指导。将血清TSH水平升高的患者的联合检测推迟至妊娠第12至13周之间可能会减少假阳性。

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