Zhou Yutian, Wang Yi, Yu Tianxiao, Li Yuan, Mi Meiyan, Su Jianqiang, Ge Jun
Research Center for Clinical Medical Sciences, The Fourth Hospital of Shijiazhuang, Shijiazhuang, China.
School of Public Health, Hebei Medical University, Shijiazhuang, China.
PeerJ. 2025 Apr 28;13:e19343. doi: 10.7717/peerj.19343. eCollection 2025.
The purpose of this study is to investigate the impact of subclinical hypothyroidism (SCH) during pregnancy and levothyroxine (LT4) therapy on pregnancy outcomes.
Among 6,510 pregnant women who came to The Fourth Hospital of Shijiazhuang for pregnancy examination and delivery, 266 pregnant women with SCH and treated with LT4 were selected as the SCH group and 672 pregnant women without SCH were selected as the non-SCH group, and the incidence rates of adverse pregnancy outcomes in pregnant women and newborns of the two groups were compared using Chi-square test and logistic regression. According to the therapeutic effect, pregnant women treated with LT4 were categorized into sustained euthyroid status (SES) and suboptimal thyroid status (STS) groups and compared with the non-SCH group using chi-square test. The correlation of thyroid stimulating hormone (TSH) levels at different stages of pregnancy was explored using Spearman's rank test.
The incidence of hypertensive disorders of pregnancy (HDP), premature rupture of membranes (PROM), and neonatal outcomes were ventricular or atrial septal defect (V/ASD), hyperbilirubinemia, and pneumonia were higher in the SCH group (SCH pregnant women) than in the non-SCH group (non-SCH pregnant women) ( < 0.05). The incidence of multiple maternal and neonatal complications was higher in the SCH-STS group (SCH in two or three gestational trimesters) compared to the SCH group. With a tendency for TSH levels to increase as the pregnancy progressed.
SCH during pregnancy is associated with a high incidence of various pregnancy complications, and LT4 therapy that controls serum TSH levels at normal levels throughout pregnancy can reduce these risks.
本研究旨在探讨妊娠期亚临床甲状腺功能减退症（SCH）及左甲状腺素（LT4）治疗对妊娠结局的影响。
在石家庄市第四医院进行产前检查及分娩的6510例孕妇中，选取266例患有SCH并接受LT4治疗的孕妇作为SCH组，选取672例未患SCH的孕妇作为非SCH组，采用卡方检验和逻辑回归比较两组孕妇及新生儿不良妊娠结局的发生率。根据治疗效果，将接受LT4治疗的孕妇分为甲状腺功能持续正常状态（SES）组和甲状腺功能未达最佳状态（STS）组，并与非SCH组进行卡方检验比较。采用Spearman秩相关检验探讨妊娠不同阶段促甲状腺激素（TSH）水平的相关性。
SCH组（SCH孕妇）的妊娠期高血压疾病（HDP）、胎膜早破（PROM）发生率以及新生儿结局中的室间隔或房间隔缺损（V/ASD）、高胆红素血症和肺炎发生率均高于非SCH组（非SCH孕妇）（P<0.05）。SCH-STS组（妊娠中晚期患SCH）母婴多种并发症的发生率高于SCH组。随着妊娠进展，TSH水平有升高趋势。
妊娠期SCH与多种妊娠并发症的高发生率相关，孕期将血清TSH水平控制在正常范围的LT4治疗可降低这些风险。
