The Research Of Effects Of Hypothyroidism On Pregnant Woman With Gestational Diabetes Mellitus

Objective:To investigate metabolic indicators of the pregnant women with gestational diabetes mellitus (GDM) complicated with hypothyroidism as well as the association of hypothyroidism with pregnancy outcomes and obstetric adverse outcomes.Methods:Pregnant women admitted in the Obstetrics and Gynecology Hospital of Tianjin center from January to August in2012.98cases of complete data of pregnant women with GDM, pregnant women in non-diabetic patients with hypothyroidism38cases. The pregnant women of late admission were detected triglyceride (TC), cholesterol (TG), high density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), thyroid stimulating hormone (TSH), creatinine(Cr), blood urea nitrogen(BUN), uric acid(UA), cystatin C(Cys-C) in the fasting state. The neonatal blood glucose were measured, TSH (0.3-3.0MIU/L)was regarded as the delimitation among groups. In this study,35cases with TSH>3.0MIU/L, as GDM and hypothyroidism group (group A),62cases with TSH0.3-3.0MIU/L, as GDM and non-hypothyroidism group (group B); non-GDM and hypothyroidism group (group C)38were used as controls.1cases with TSH<0.3MIU/L as hyperthyroidism group, due to only1, without statistical significance, wasn’t compared. Group A compared with group B and group C, respectively, the clinical metabolic indicators, pregnancy outcomes and newborn adverse outcomes, including gestational hypertension, placental abruption, premature birth, neonatal asphyxia, neonatal hypoglycemia. Group A compared with group B and group C, respectively, the TSH of the newborn. Results:Compared with group B, TG, LDL-C, Cr were higher in group A, the difference was statistically significant, the other metabolic indicators without statistical significance; The fasting blood glucose, postprandial blood glucose and HbAlc of the patients in Group A was lower than group B, fasting blood glucose was statistically different. There was positive correlation indicators of glucose metabolism and FT3, FT4; negative correlation between TSH and HbAlc; Compared with group B, the incidence of hypertension was higher in group A, the difference was statistically significant, premature rupture of membranes, placental abruption, postpartum hemorrhage, premature birth, neonatal hypoglycemia, neonatal asphyxia incidence between the two groups was not statistically different, but the premature rupture of membranes, postpartum hemorrhage, preterm birth rate in group A were significantly higher than group B. Compared with group C, TG, LDL-C, Cr were higher in group A, the difference was statistically significant, the others without statistical significance; Pregnancy outcome and newborn adverse outcomes weren’t significantly different between group A and group C. There was positive correlation between cord blood and heel blood about TSH. The difference between cord blood and heel blood about TSH was statistically significant between group A and group B. The difference between heel blood and cord blood about TSH wasn’t statistically significant between group A and group C.Conclusion:Hypothyroidism may aggravate the occurrence of metabolic disorders and adverse pregnancy outcomes for pregnant women with GDM. It is recommended that pregnant women with GDM should be screened thyroid function, thyroid function abnormalities should be treated. Maternal hypothyroidism affects on TSH levels of both newborn cord blood and heel blood.