Investigation On Thyroid Diseases Of700Cases Of Pregnant Women From Outpatient Service In Nanchang

Objective：Through thyroid screening during pregnancy in order to discuss the incidence ofthyroid disease in the first trimester,the second trimester and the third trimestr ofpregnancy,for purpose of early detection,diagnosis,treatment.At the same time toinvestigate the relation between thyroid peroxidase(thyriod peroxidase antibody,TPOAb)and Subclinical hypothyroidism disease(Subclinical hypothyroidism, SCH).Methods：Screening for prenatal women to Jiangxi maternal and child health hospitalobstetrics clinic for antenatal care in Nanchang City from March,2013to February,2014,all selected participants is divided into the first trimester(1to12gestationalweeks),the second trimester(13to27gestational weeks)and the third trimestr(28to40gestational weeks).(2)respectivly detect the serum TPOAb, thyroid stimulatinghormone (thyroid-stimulating hormone, TSH) and serum free thyroxine (freethyroxine, three, FT4) of serum freetriiodothyronine (free Triiodothryonine, FT3)level. Factor TPOAb positive and subclinical hypothyroidism impact analysis usingtwo Logistic regression.Results：Collect cases700,217cases in the first trimester of pregnancy,251cases in thesecond trimester ofpregnancy,232cases in the third trimestr of pregnancy.(1) The total prevalence rate of abnormal thyroid function and thyroidperoxid-ase antibody positive in the three trimester of pregnancy: Abnormal thyroidfu-nction and thyroid peroxidase antibody positive were132cases,the total inciden-cerate was18.9%(132/700);subclinical hypothyroidism were41cases,the incide-ncerate was5.9%(41/700);hypothyroxinemia were24cases,the incidence rate was3.4%(24/700);subclinical hyperthyroidism were12cases,the incidence rate was1.7%(12/700); hyperthyroidism were4cases,the incidence rate was0.05%(4/700); clinicalhypothyroidism was1case,the incidence rate was0.01%(1/700). TPOAb (+) were 51cases,the total incidence rate was7.3%(51/700), including18cases with normalthyroid function,the incidence rate was2.6(18/700);33cases with abnormal thyroidfunction,the incidence of4.7%(33/700).(2) The incidence of thyroid diseases during the three trimester of pregnancy:The first trimester: the prevalence rate of lower T4is1.8%(4/217), the prevalencerate of subclinical hypothyroidism is7%(15/217), the prevalence rate of subclinicalhyperthyriodism is1.8%(4/217), the prevalence rate of hyperthyroidism is1.4%(3/217), the prevalence rate of hypothyroidism is0.5%(1/217); the secondtrimester: the prevalence rate of lower T4is4.4%(11/251), the prevalence rate ofsubclinical hypothyroidism is6.4%(16/251), the prevalence rate of subclinicalhyperthyriodism is2.4%(6/251), the prevalence rate of hyperthyroidism is0.4%(1/251), the prevalence rate of hypothyroidism is0%; the third trim-estr: theprevalence rate of lower T4is3.9%(9/232), the prevalence rate of subclinicalhypothyroidism is4.3%(10/232), the prevalence rate of subclinical hyperthyriodismis0.9%(2/232), the prevalence rate of hyperthyroidism is0%(0/232), the prevalencerate of hypothyroidism is0%(0/232).Nostatistically significant differences inprevalence rate of thyroid disease during each stage of pregnancy (2=2.516,P=0.284).(3) the incidence rate of TPOAb positive with normal thyroid function and withabnormal thyroid function during the three trimester of pregnancy:The firsttrimester: the total prevalence rate of TPOAb positive is9.2%(20/217);Withabnormal thyroid function is6%(13/217),With euthyroidism is3.2%(7/217). thesecond trimester: the total prevalence rate of TPOAb positive is7.6(19/251); Withabnormal thyroid function is4.4%(11/251); With euthyroidism is3.2%(8/251). thethird trimestr: the total prevalence rate of TPOAb positive is5.2%(12/232); Withabnormal thyroid function is3.9%(9/232), With euthyroidism is1.3%(3/232). Theprevalence rate of TPOAb positive showed no statistical significance among thethree group of pregnancy (2=3.657, P=0.161), the prevalence rate of TPOAbpositive with normal thyroid function and with thyroid dysfunction were statisticallysignificant among the three trimester of pregnancy (2=190.001, P <0.001).(4) The incidence of subclinical hypothyroidism with TPOAb positive and negative during the three trimester of pregnancy:The first trimester: subclinicalhypothyroidism with TPOAb positive is4.6%(10/217), with TPOAb negative is2.3%(5/217). the second trimester: subclinical hypothyroidism with TPOAbpositiveis is3.5%(9/251), with TPOAb negative is2.8%(6/251).the third trimestr:subclinical hypothyroidism with TPOAb positive is2.5%(7/232), with TPOAbnegative is1.3%(4/232). Subclinical hypothyroidism patients during each stage ofpregnancy with TPOAb positive and with TPOAb negative is statistically significant(2=259.529, P <0.001), multiple Logistic regression analysis of TPOAb positive,gestational age, age related subclinical hypothyroidism during each stage ofpregnancy, the results showes TPOAb positive is one of the risk factors forsubclinical hypothyroidism.Conclusion：(1) Subclinical hypothyroidism disease is common encountered disease ingestational；gestational age have little influence on the prevalence rate of thyroiddisease in pregnancy.(2) TPOAb positive is a risk factor for subclinical hypothyroidism.