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焦虑和抑郁对妊娠晚期甲状腺功能减退症孕妇的不良影响。

The Adverse Effects of Anxiety and Depression on Pregnant Women with Hypothyroidism in Late Pregnancy.

机构信息

Endocrine Department Ward 1, Zhangjiakou First Hospital, 075000 Zhangjiakou, Hebei, China.

Intemal Medicine-Neurology Ward 2, Zhangjiakou First Hospital, 075000 Zhangjiakou, Hebei, China.

出版信息

Actas Esp Psiquiatr. 2024 Oct;52(5):625-631. doi: 10.62641/aep.v52i5.1644.

Abstract

BACKGROUND

Maternal depression and anxiety during pregnancy are significant public health concerns commonly reported worldwide among pregnant women. This study aimed to investigate the impact of anxiety and depression on thyroid function, pregnancy outcomes, and sleep quality among pregnant women with hypothyroidism in the later stages of pregnancy.

METHODS

Eighty cases of pregnant women with hypothyroidism in late pregnancy who were treated at Zhangjiakou First Hospital from January 2021 to October 2023 were selected for this retrospective study. The pregnant women in late pregnancy were divided into four groups according to the scores on the Hospital Anxiety and Depression Scale (HADS): control group with 20 cases, anxiety group with 18 cases, depression group with 22 cases, and anxiety-depression group with 20 cases. A comparison was made among the four groups regarding general information of pregnant women in late pregnancy, HADS scale scores, levels of free thyroxine (FT4, FT3), thyroid-stimulating hormone (TSH), occurrence of adverse pregnancy outcomes, and sleep quality at different time periods.

RESULTS

There was no statistically significant difference in comparing general information among the four groups of pregnant women in late pregnancy (p > 0.05). There were statistically significant differences in HADS depression and HADS anxiety scores (p < 0.05), levels of FT4, FT3, TSH in pregnant women in late pregnancy postpartum (p < 0.05), occurrence of adverse pregnancy outcomes (p < 0.05), and comparison of sleep quality of pregnant women in late pregnancy at 1, 3, and 5 months of follow-up among the groups (F = 5.735, 23.930, 11.573, p < 0.05).

CONCLUSION

Anxiety and depression significantly impact thyroid function, pregnancy outcomes, and sleep quality in pregnant women with hypothyroidism in late pregnancy, which is detrimental to the health of pregnant women in late pregnancy. Therefore, necessary interventions are needed.

摘要

背景

孕期抑郁和焦虑是全球范围内普遍报道的重大公共卫生问题。本研究旨在探讨焦虑和抑郁对妊娠晚期甲减孕妇甲状腺功能、妊娠结局和睡眠质量的影响。

方法

选取 2021 年 1 月至 2023 年 10 月在张家口第一医院治疗的 80 例妊娠晚期甲减孕妇进行回顾性研究。根据医院焦虑抑郁量表(HADS)评分,将晚期妊娠孕妇分为四组:对照组 20 例,焦虑组 18 例,抑郁组 22 例,焦虑抑郁组 20 例。比较四组孕妇的一般资料、HADS 评分、游离甲状腺素(FT4、FT3)、促甲状腺激素(TSH)水平、不良妊娠结局发生率和不同时间点的睡眠质量。

结果

四组孕妇的一般资料比较差异无统计学意义(p>0.05)。HADS 抑郁和 HADS 焦虑评分(p<0.05)、妊娠晚期孕妇产后 FT4、FT3、TSH 水平(p<0.05)、不良妊娠结局发生率(p<0.05)、四组孕妇妊娠晚期 1、3、5 个月随访时睡眠质量比较(F=5.735、23.930、11.573,p<0.05)差异有统计学意义。

结论

焦虑和抑郁显著影响妊娠晚期甲减孕妇的甲状腺功能、妊娠结局和睡眠质量,对妊娠晚期孕妇的健康有害。因此,需要进行必要的干预。

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本文引用的文献

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Management of Hypothyroidism and Hypothyroxinemia During Pregnancy.妊娠期甲状腺功能减退症与甲状腺素血症的管理。
Endocr Pract. 2022 Jul;28(7):711-718. doi: 10.1016/j.eprac.2022.05.004. Epub 2022 May 13.

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