Liu Jiaming, Xie Xinglei, García-Patterson Apolonia, Asla Queralt, Sardà Helena, Chico Ana, Adelantado Juan M, Urgell Eulàlia, Corcoy Rosa
Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.
Institut de Recerca, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Arch Gynecol Obstet. 2024 Aug;310(2):961-969. doi: 10.1007/s00404-023-07279-z. Epub 2023 Nov 19.
Gestational weight gain (GWG) is an important contributor to pregnancy outcomes in the general obstetric population and different subgroups. The corresponding information in women with thyroid conditions is limited. We aimed to evaluate the relationship between GWG according to institute of medicine (IOM) and pregnancy outcomes in women with thyroid disorders.
We performed a retrospective analysis of 620 pregnant women either treated with levothyroxine (N = 545) or attended because of hyperthyroidism during pregnancy (N = 75).
The associations between GWG according to IOM and pregnancy outcomes were present both in women treated with thyroid hormone and women followed by hyperthyroidism, most of them related to the fetal outcomes. In women treated with levothyroxine, insufficient GWG was associated with gestational diabetes mellitus (GDM) (odds ratio (OR) 2.32, 95% confidence interval (CI) 1.18, 4.54), preterm birth (OR 2.31, 95% CI 1.22, 4.36), small-for-gestational age newborns (OR 2.38, 95% CI 1.09, 5.22) and respiratory distress (OR 6.89, 95% CI 1.46, 32.52). Excessive GWG was associated with cesarean delivery (OR 1.66, 95% CI 1.10, 2.51) and macrosomia (OR 2.75, 95% CI 1.38, 5.49). Large-for-gestational age newborns were associated with both insufficient GWG (OR 0.25, 95% CI 0.11, 0.58) and excessive GWG (OR 1.80, 95% CI 1.11, 2.92). In women followed by hyperthyroidism, excessive GWG was associated with large-for-gestational age newborns (OR 5.56, 95% CI 1.03, 29.96).
GWG according to IOM is associated with pregnancy outcomes both in women treated with thyroid hormone and women followed by hyperthyroidism.
孕期体重增加（GWG）是普通产科人群及不同亚组妊娠结局的重要影响因素。甲状腺疾病女性的相关信息有限。我们旨在评估根据医学研究所（IOM）标准的GWG与甲状腺疾病女性妊娠结局之间的关系。
我们对620名孕妇进行了回顾性分析，其中545名接受左甲状腺素治疗，75名因孕期甲状腺功能亢进就诊。
在接受甲状腺激素治疗的女性和甲状腺功能亢进随访的女性中，根据IOM标准的GWG与妊娠结局均有关联，其中大多数与胎儿结局相关。在接受左甲状腺素治疗的女性中，GWG不足与妊娠期糖尿病（GDM）（比值比（OR）2.32，95%置信区间（CI）1.18，4.54）、早产（OR 2.31，95% CI 1.22，4.36）、小于胎龄儿（OR 2.38，95% CI 1.09，5.22）和呼吸窘迫（OR 6.89，95% CI 1.46，32.52）相关。GWG过度与剖宫产（OR 1.66，95% CI 1.10，2.51）和巨大儿（OR 2.75，95% CI 1.38，5.49）相关。大于胎龄儿与GWG不足（OR 0.25，95% CI 0.11，0.58）和GWG过度（OR 1.80，95% CI 1.11，2.92）均相关。在甲状腺功能亢进随访的女性中，GWG过度与大于胎龄儿（OR 5.56，95% CI 1.03，29.96）相关。
根据IOM标准的GWG与接受甲状腺激素治疗的女性和甲状腺功能亢进随访的女性的妊娠结局均有关联。
