Test Results And Correlation Analysis Of Preconception Thyroid Stimulating Hormone In Women Planning Pregnancy In Dalian From 2016 To 2017

Objective : TSH is the most sensitive and important indicator for assessing thyroid function.This study counted the preconception TSH indicators of women planning pregnancy in Dalian from 2016 to 2017,and analyzed of risk factors related to abnormal TSH;compared the pregnancy process and pregnancy outcomes of women with subclinical thyroid dysfunction,analyzed the impact of subclinical thyroid dysfunction on women pregnancy and adverse pregnancy outcomes,pay attention to the thyroid function examination of women before pregnancy and the management of women with subclinical thyroid dysfunction,in order to reduce the occurrence of adverse pregnancy outcomes,achieve the purpose of preventing birth defects and improving the quality of the birth population.Materials and Methods:A total of 18820 cases of pregnant women who participated in the National Free Pre-Pregnancy Health Checkup Project in Dalian from January 1,2016 to December 31,2017 were collected,and the diagnosis and treatment of thyroid disease and pregnancy outcomes were followed up.Specifically divided into the following three parts.(1)Calculate TSH abnormal detection results.To analyze the correlation between TSH and age,body mass index,fasting plasma glucose,education,family history of thyroid disease,dietary habits,work styles,psychological stress,smoking,alcohol consumption,and physical and chemical environment exposure history.(2)302 women with subclinical thyroid dysfunction without other infertility-causing diseases were selected as the research group,of which 204 were in the subclinical hypothyroidism group and 98 were in the subclinical hyperthyroidism group,302 healthy women were randomly selected as the control group.Retrospectively counted the pregnancy and infertility of these women,and compared with the control group by statistical method.(3)166 monotocous women with subclinical thyroid dysfunction and without risk factors before pregnancy were selected as the research group,of which 21 cases in the untreated subclinical hyperthyroidism(group A),42 cases in the treated subclinical hyperthyroidism group(group B),53 cases in the untreated subclinical hypothyroidism group(group C),50 cases in the treated subclinical hypothyroidism group(group D),53 healthy women were randomly selected as the control group(group E).To count abortion,GDM,gestational hypertension,anemia,premature rupture of membranes,placental abruption,cesarean section,premature birth,low birth weight infants,fetal distress,fetal malformation,The pregnancy outcomes were compared with the control group by statistical method.Results:(1)From 2016 to 2017,there were a total of 18820 pregnant women participated in the National Free Pre-Pregnancy Health Checkup Project in Dalian.The incidence of abnormal TSH was 7.8%,of which 5.42% are higher than the upper limit of its normal reference range,lower than the lower limit of its normal reference range is 2.40%.Compared the incidence of abnormal TSH in different age groups,and the difference was statistically significant(X2 = 609.878,P <0.05),the incidence of abnormal detection increased with age(X2 = 581.431,P <0.05).Single factor analysis showed that age,body mass index,fasting plasma glucose,family history of thyroid disease,psychological stress,and history of physical and chemical environment were associated with abnormal TSH(all P <0.05).Multivariate regression analysis showed that age,body mass index,higher fasting plasma glucose,family history of thyroid disease,and psychological stress were independent risk factors for abnormal TSH.(2)The incidence of infertility in subclinical hypothyroidism and subclinical hyperthyroidism was 14.2% and 13.3% respectively,which was higher than that in the control group(4.6%),and the difference was statistically significant(all P <0.05).(3)Compared with groups B and E,group A had a higher incidence of abortion and GDM,and the difference was statistically significant(all P <0.05);group A had a higher incidence of gestational hypertension than the other four groups(all P<0.05).Compared with groups D and E,the incidence of abortion and GDM was higher in group C(P <0.05);the incidence of low birth weight infants was higher in group C than that in other four groups(all P<0.05).There were no significant differences in the pregnancy outcomes between the group B,D,and E(all P> 0.05).Conclusion:(1)The incidence of abnormal TSH in women planning pregnancy in Dalian is at a slightly higher level than other regions in China.TSH is related to age,body mass index,hyperglycemia,family history of thyroid disease,and psychological stress.Age-appropriate pregnancy,controlling weight and plasma glucose,and alleviating psychological stress can reduce the incidence of thyroid disease.Particular attention the detection of thyroid function in women with family history of thyroid disease.(2)Subclinical thyroid dysfunction can increase the risk of female infertility,abortion,gestational hypertension,GDM and low birth weight infants.(3)Pay attention to the detection of thyroid function to women before pregnancy,and actively treat subclinical thyroid dysfunction can effectively improve the adverse pregnancy outcomes.