Correlation Of Thyroid Disease And GDM In Pregnant Women And Its Effects On Pregnancy Outcomes And Intervention

Objective Thyroid disease is common in women of childbearing age，and in recentyears gestational diabetes mellitus (GDM) have shown an increasing trend due to theimprovement of living standards. Given pregnancy can have an impact on the body’sentire endocrine system，this article aims to observe the relationship between thyroiddiseases and GDM.It also aims to observe the influence of thyroid disease onpregnancy complications and to verify if drug intervention (LT4) can improve thepregnancy outcomes.Methods The study objects is pregnant women conduct obstetric care and deliveriesin Shanghai First People’s Hospital during February2012to November2013. In thebeginning of the second trimester, with the screened of thyroid hormones andantibodies and GDM, the article aims to observe the morbidity of thyroid disease andGDM and the dynamic changes of thyroid hormone levels during pregnancy. It alsoaims to observe the affect on pregnancy complications and newborn, as well as toobserve if levothyroxine (L-T4) intervention could improve pregnancy outcomes inpregnant women with thyroid diseaseResults Our study enrolled a total of2,113cases of pregnant women, and1,974cases have no previous history of thyroid disease and diabetes.In1974observedobjects, the prevalence of thyroid disease is37.84%, including patients withsubclinical hypothyroidism which accounted largest proportion of19.55%. It foundthat pregnant women with gestational diabetes have a higher incidence of thyroiddisease than those without gestational diabetes (ratio47.35%vs36.37%, P=0.001).Maternal serum thyroid hormone levels may fluctuate within the normal range duringpregnancy in normal group, while TSH is rising and the FT3, FT4on the decline. Thepregnancy women with thyroid disease appeared to be higher incidence of gestationaldiabetes, premature rupture of membranes, maternal probability fetal growthrestriction, premature birth than normal group, the difference was statistically significant（P<0.05). Subclinical hypothyroidism, subclinical hypothyroidism, serumTPOAb positive pregnant women are at higher risk of obstetric complications, and theintervention of drug (LT4) can reduce the incidence of obstetric complications and theTSH values, which had no significant influence on serum FT3, FT4levels.Conclusions Our results suggests that many "normal" pregnant women can bedetected with thyroid disease and GDM during pregnancy. A higher prevalence ofpregnant thyroid disease was found in pregnancy women with GDM, comparedwithout GDM in our study. Maternal serum thyroid hormone levels may fluctuatewithin the normal range during pregnancy in normal group. Thyroid dysfunctionduring pregnancy may increase the incidence of obstetric complications and impacton neonatal. Using positive drug intervention should improve obstetrical outcomes.