孕12周前亚甲减的治疗对妊娠结局及12月龄子代发育的影响(1)
[摘要] 目的 探討孕12周前亚甲减的治疗对妊娠结局及12月龄子代发育的影响。 方法 选取2016年6月～2017年12月在宁波城区妇幼保健门诊进行初次产检建册的<12周的单胎孕妇。产前：将被诊断为亚甲减的孕妇随机分为治疗组(217例)和观察组(152例)，治疗组给予L-T4治疗。同期无异常孕妇为对照组(8001例)，比较各组妊娠结局。产后：亚甲减的孕妇中无其他合并症并足月分娩的子代作为(子代)治疗组(136例)和(子代)观察组(93例)，对照组中随机抽取无合并症且足月分娩的子代作为(子代)对照组(186例)。分析各组体格及智能发育情况。 结果 观察组早产率及糖尿病患病率高于对照组及治疗组(P<0.05);三组的足月小样儿、流产或死胎、出生缺陷发生率及妊娠期高血压、围产儿先天性心脏病发病率无差异(P>0.05)。(子代)观察组新生儿体重低于(子代)对照组和(子代)治疗组(P<0.05);12月龄时(子代)观察组身高低于(子代)对照组和(子代)治疗组(P<0.05)，三组体重无统计学差异(P>0.05)。三组发育商构成比有统计学差异(P<0.05);大运动及语言：(子代)对照组高于(子代)治疗组及(子代)观察组(P<0.05);精细动作：(子代)观察组低于(子代)对照组和(子代)治疗组(P<0.05)。 结论 孕早期亚临床甲减会增加早产及糖尿病风险，影响新生儿出生体重、12月龄时体格及某些方面智能发育，早期治疗可改善上述状况。
[关键词] 亚临床甲状腺功能减退;左旋甲状腺素;早产;流产;妊娠期糖尿病;妊娠期高血压疾病;盖泽尔发育量表;出生缺陷
[中图分类号] R714.256 [文献标识码] B [文章编号] 1673-9701(2020)02-0067-05
The influence of treatment of hypothyroidism before the 12th week of pregnancy on pregnancy outcomes and the development of 12-month-old children
SUN Ying LV Lanqiu YANG Xiuping
Department of Maternal and Child Health Care， Ningbo Women and Children's Hospital in Zhejiang Province， Ningbo 315012， China
[Abstract] Objective To investigate the influence of treatment of hypothyroidism before the 12th week of pregnancy on pregnancy outcomes and the development of 12-month-old children. Methods A single-fetal pregnant woman with establishing medical records at <12 weeks in the maternal and child health clinic of Ningbo urban area from June 2016 to December 2017 were selected. Prenatal： The pregnant women diagnosed with hypothyroidism were randomly divided into the treatment group(217 cases) and the observation group(152 cases). The treatment group was given L-T4 treatment. The pregnant women without abnormality in the same period were set as the control group(8001 cases). And the pregnancy outcomes of each group were compared. Postpartum： The children with no comorbidities of the pregnant women with hypothyroidism and the full-term delivery were treated as(child) treatment group(136 cases) and(child) observation group(93 cases). The children of full-term delivery with no comorbidities in the control group were used as the(child) control group(186 cases). The physical and intelligent development of each group was analyzed. Results The preterm birth rate and diabetes prevalence in the observation group were higher than those in the control group and the treatment group(P<0.05). There was no difference in the full-term small for gestational age infants， abortion or stillbirth， incidence of birth defects， incidence of hypertension during pregnancy and congenital heart disease in the three groups(P>0.05). The neonatal weight of the(child) observation group was lower than that of the(child) control group and the(child) treatment group(P<0.05). At 12 months of age， the height of the(child) observation group was lower than that of the child control group and the(child) treatment group(P<0.05). And there was no significant difference in body weight between the three groups(P>0.05). There were significant differences in developmental quotients in the three groups(P<0.05). The developmental quotients of large exercise and language in(child) control group were higher than those of the(child) treatment group and(child) observation group(P<0.05). The developmental quotient of fine action in the(child) observation group was lower than that of(child) control group and(child) treatment group(P<0.05). Conclusion Subclinical hypothyroidism in early pregnancy increases the risk of premature birth and diabetes， affects the birth weight of the newborn and the physical development of some aspects at 12 months of age. Early treatment can improve the above situation., http://www.100md.com(孙莹 吕兰秋 杨秀萍)
[关键词] 亚临床甲状腺功能减退;左旋甲状腺素;早产;流产;妊娠期糖尿病;妊娠期高血压疾病;盖泽尔发育量表;出生缺陷
[中图分类号] R714.256 [文献标识码] B [文章编号] 1673-9701(2020)02-0067-05
The influence of treatment of hypothyroidism before the 12th week of pregnancy on pregnancy outcomes and the development of 12-month-old children
SUN Ying LV Lanqiu YANG Xiuping
Department of Maternal and Child Health Care， Ningbo Women and Children's Hospital in Zhejiang Province， Ningbo 315012， China
[Abstract] Objective To investigate the influence of treatment of hypothyroidism before the 12th week of pregnancy on pregnancy outcomes and the development of 12-month-old children. Methods A single-fetal pregnant woman with establishing medical records at <12 weeks in the maternal and child health clinic of Ningbo urban area from June 2016 to December 2017 were selected. Prenatal： The pregnant women diagnosed with hypothyroidism were randomly divided into the treatment group(217 cases) and the observation group(152 cases). The treatment group was given L-T4 treatment. The pregnant women without abnormality in the same period were set as the control group(8001 cases). And the pregnancy outcomes of each group were compared. Postpartum： The children with no comorbidities of the pregnant women with hypothyroidism and the full-term delivery were treated as(child) treatment group(136 cases) and(child) observation group(93 cases). The children of full-term delivery with no comorbidities in the control group were used as the(child) control group(186 cases). The physical and intelligent development of each group was analyzed. Results The preterm birth rate and diabetes prevalence in the observation group were higher than those in the control group and the treatment group(P<0.05). There was no difference in the full-term small for gestational age infants， abortion or stillbirth， incidence of birth defects， incidence of hypertension during pregnancy and congenital heart disease in the three groups(P>0.05). The neonatal weight of the(child) observation group was lower than that of the(child) control group and the(child) treatment group(P<0.05). At 12 months of age， the height of the(child) observation group was lower than that of the child control group and the(child) treatment group(P<0.05). And there was no significant difference in body weight between the three groups(P>0.05). There were significant differences in developmental quotients in the three groups(P<0.05). The developmental quotients of large exercise and language in(child) control group were higher than those of the(child) treatment group and(child) observation group(P<0.05). The developmental quotient of fine action in the(child) observation group was lower than that of(child) control group and(child) treatment group(P<0.05). Conclusion Subclinical hypothyroidism in early pregnancy increases the risk of premature birth and diabetes， affects the birth weight of the newborn and the physical development of some aspects at 12 months of age. Early treatment can improve the above situation., http://www.100md.com(孙莹 吕兰秋 杨秀萍)
参见：首页 > 医疗版 > 疾病专题 > 内分泌科 > 甲状腺疾病 > 甲减