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原发性干燥综合征/自身免疫性甲状腺疾病妊娠的母婴结局回顾性分析

A retrospective analysis on maternal and neonatal outcomes in pSS/AITD pregnancies.

作者信息

Peng Miaoguan, Luo Taizhen, Weng Xiaoshi, Dong Yanmei, Xie Yijuan, Huang Siqi, Liang Naifeng, Wen Shiyun, Zhai Yaojie, Xie Yingjun, Chen Yuyi

机构信息

Department of Endocrinology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510150, China.

Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, 510170, China.

出版信息

Sci Rep. 2025 Jan 27;15(1):3437. doi: 10.1038/s41598-024-83937-9.

Abstract

The combined impact of concurrent primary Sjögren's syndrome (pSS) and autoimmune thyroid disease (AITD) on pregnancy outcomes remains underreported. A retrospective analysis was conducted on 115 pregnant patients diagnosed with pSS and delivering at the Third Affiliated Hospital of Guangzhou Medical University from January 2009 to July 2023. The effects of AITD on maternal and neonatal outcomes were examined and compared to a control group without AITD. In the group with pSS and AITD, the pregnancy loss rate was significantly higher than in the non-AITD group (P = 0.015), primarily reflected in the increased rate of neonatal death (P = 0.029). The proportion of term births and vaginal deliveries in the AITD group was notably reduced compared to the non-AITD group (54% vs. 81.5%; 16.0% vs. 41.5%; P = 0.001 and P = 0.003, respectively). No significant differences were observed in other maternal pregnancy outcomes, including induced abortion, spontaneous abortion, therapeutic abortion, and premature delivery (P > 0.05). The average birth weight of newborns in the pSS with AITD group was significantly lower than in the pSS without AITD group (2587.70 ± 720.50 g vs. 2812.54 ± 495.30 g, P < 0.001). Additionally, the rate of low-birth-weight infants in the pSS with AITD group was higher than in the pSS without AITD group (39.0% vs. 19.7%, P = 0.032). However, no significant differences were found between the two groups in the rates of fetal death, neonatal live birth, and fetal distress (P > 0.05). These results emphasize the importance of monitoring and managing thyroid health during pregnancy to optimize maternal and neonatal outcomes. Further exploration is essential to unravel the precise mechanisms through which AITD impacts fetal growth and to identify potential interventions to mitigate these effects.

摘要

原发性干燥综合征(pSS)与自身免疫性甲状腺疾病(AITD)同时存在对妊娠结局的综合影响仍鲜有报道。对2009年1月至2023年7月在广州医科大学附属第三医院分娩的115例诊断为pSS的孕妇进行了回顾性分析。研究了AITD对母婴结局的影响,并与无AITD的对照组进行比较。在pSS合并AITD组中,妊娠丢失率显著高于非AITD组(P = 0.015),主要表现为新生儿死亡率增加(P = 0.029)。与非AITD组相比,AITD组的足月产率和阴道分娩率显著降低(分别为54% 对81.5%;16.0% 对41.5%;P = 0.001和P = 0.003)。在其他孕产妇妊娠结局方面,包括人工流产、自然流产、治疗性流产和早产,未观察到显著差异(P > 0.05)。pSS合并AITD组新生儿的平均出生体重显著低于无AITD的pSS组(2587.70±720.50 g对2812.54±495.30 g,P < 0.001)。此外,pSS合并AITD组低出生体重儿的发生率高于无AITD的pSS组(39.0%对19.7%,P = 0.032)。然而,两组在胎儿死亡、新生儿活产和胎儿窘迫发生率方面未发现显著差异(P > 0.05)。这些结果强调了孕期监测和管理甲状腺健康以优化母婴结局的重要性。进一步探索对于阐明AITD影响胎儿生长的精确机制以及确定减轻这些影响的潜在干预措施至关重要。

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