Epidemiological Survey Of Thyroid Function Of Pregnant Women In Han Nationality In Shaanxi Province

Objective:1.Establish the reference value range of thyroid function indexes of Han women during pregnancy in Shaanxi Provincial People’s Hospital,and analyze the research status of thyroid function in pregnancy in various regions of Shaanxi Province.2.The changing trend of thyroid indicators during pregnancy and postpartum.3.Comparison of the prevalence of SCH(Subclinical Hypothyroidism)under different diagnostic criteria.4.SCH and simple TPOAb(Thyroid peroxidase antibody,thyroid peroxidase antibody)Relationship with pregnancy complications.Method:A retrospective analysis was conducted in the obstetrics department of our hospital from October 1,2018 to January 1,2020.The thyroid function was normal before pregnancy and the serological indicators of thyroid function in the first trimester were complete.Collect general data information for all people,such as: name,age,place of residence,etc.;collect glucose tolerance,whether there is pregnancy hypertension and other complications;prenatal ultrasound,blood routine,newborn weight,length and postpartum thyroid Function and other indicators.Enter all the collected data into an Excel table and use SPSS 26 for data analysis.Results:1.The reference values of serum TSH(Thyroid Stimulating Hormone)in the early,middle and late pregnancy of our hospital are: 1.69(0.15～5.12)uIu/ml,2.30(0.24～5.78)uIu/ml,2.83(0.94～ 6.56)uIu/ml.The reference values of serum FT4(Free thyroxine)are: 15.90(11.29～21.50)pmol/L,13.82(9.96-20.94)pmol/L,7.73(9.60-19.84)pmol/L.2.The serum TSH of Beilin District,Yanta District,Lianhu District,Chang’an District and Weiyang District in Xi’an city were not statistically different.Based on the literature search of the reference range of thyroid gland during pregnancy in Shaanxi Province,it is found that the reference range of thyroid gland during pregnancy has been studied in other cities except Xi’an.3.The trend of thyroid function changes:(1)Serum TSH was the lowest in early pregnancy,and increased gradually with gestational age.There was significant difference between early pregnancy and late pregnancy,mid pregnancy and late pregnancy.(2)Serum FT3 was the highest in early pregnancy,and decreased with the increase of gestational age.The difference was statistically significant(P < 0.05)between early pregnancy and late pregnancy,mid pregnancy and late pregnancy;(3)FT4 was the highest in early pregnancy,and decreased with the decrease of gestational age.The difference was statistically significant(P < 0.05)between early pregnancy and mid pregnancy.4.Analysis of postpartum thyroid function: according to the discharge diagnosis of our hospital,the prevalence of pregnancy with subclinical hypothyroidism was 6.14%,and the follow-up rate was 61.40%.Change trend of TSH: with the increase of gestational age,TSH is decreasing gradually,reaching the lowest value in late pregnancy,and increasing gradually after delivery;change trend of serum FT4,with the increase of gestational age,FT4 is decreasing gradually,reaching the lowest value in late pregnancy,and increasing trend of postpartum FT4.5.Comparison of the prevalence of thyroid diseases under different diagnostic criteria: the prevalence of early pregnancy Sch calculated by the reference values of Roche reagent in 2019,2012,2011 ata,our laboratory and this study were 4.7%,2.96%,29.6%,7.8% and 3.23%,respectively.Among them,there was no statistical significance(P = 0.25)in the prevalence rate of early pregnancy Sch diagnosed by Roche reagent in 2012 and the reference value of this study,and the consistency was good.There was significant difference in other prevalence rates(P < 0.001).6.Antithyroid peroxidase antibody(TPOAb)is associated with hypothyroidism.7.Compared with the group with normal thyroid function,the incidence of adverse pregnancy outcomes with negative TPO in Sch group was higher than that in the group with normal thyroid function,such as hypertension,diabetes,anemia,cesarean section rate,low birth weight infants,macrosomia,premature delivery,abortion and fetal malformation.Compared with normal thyroid function group,TPO positive group had higher incidence of hypertension,thrombocytopenia,cesarean section,low birth weight and abortion.conclusion1.The reference value range of TSH and FT4 in pregnant women was established.2.Except for Xi’an,there are few studies on the reference value of thyroid function in Shaanxi Province.3.The thyroid function in pregnancy is fluctuant,and the thyroid function in postpartum is returning to normal.4.TPOAb is related to thyroid disease.5.Subclinical hypothyroidism and pure TPOAb positive may increase the risk of pregnancy complications and adverse pregnancy outcome.