Analysis Of The Related Factors Of Hyperthyroidism Relapse After Drug Withdrawal In Early Pregnancy And Its Effect On The Pregnancy Outcomes

Objectives:The comparative analysis of the clinical data of patients with hyperthyroidism combined pregnancy relapse and no relapse after drug withdrawal in early pregnancy,to explore the incidence and risk factors of hyperthyroidism relapse after drug withdrawal in the early weeks of pregnancy and it’s effects on pregnancy outcomes.Methods:The study was conducted on 54 cases of patients with hyperthyroidism combined pregnancy during September 2014 to March 2017 in our hospital,these patients have drug withdrawal in the early pregnancy(≤6w),and the clinical data were followed up,according to whether hyperthyroidism relapse after drug withdrawal will be divided into the relapse group and no relapse group,using statistical methods to analyze the relationship between hyperthyroidism relapse and related factors include age,duration of hyperthyroidism,history of abortion,history of childbirth,family history,smoking history,the level of thyrotropin(TSH),thyrotrophin receptor antibody(TRAb),thyroid-peroxidase antibody(TPOAb)and thyroglobulin antibody(TgAb)when drug withdrawal,in addition,to analyze the effects of hyperthyroidism relapse after drug withdrawal in early pregnancy on pregnancy outcomes,maternal complications and the adverse outcome of perinatal infant.All the data were analyzed by statistical T test or?~2test,and the Logistic regression model was used to analyze multiple factors with statistical significance.Results:(1)From the follow-up of the level of thyroid stimulating hormone(TSH),serum free thyroxine(FT4),free three iodine armour gland original glycine(FT3)of the54 patients,the result shows that a total of 18 patients with relapse after the drug was stopped,the cumulative relapse rate was 33.33%.(2)Compare the patients of the two groups about age,duration of hyperthyroidism,history of abortion,history of childbirth,family history,smoking history and the level of TSH,TGAb,TPOAb and TRAb when have drug withdrawal,found the differences of TSH,TRAb between the two groups have statistically significant(P<0.05);Logistic regression analysis showed that the low level of TSH and positive TRAb are independent risk factors of hyperthyroidism relapse after discontinuation in early pregnancy(P<0.05).(3)The adverse pregnancy outcomes of maternal and perinatal infant:the incidence rates of premature birth,abortion,induced labor,gestational diabetes,gestational hypertension diseases,low birth weight,deformity and stillbirth in the relapse group are higher than did not relapse group,the difference was statistically significant(P<0.05).Conclusion:For patients with hyperthyroidism have low level of TSH or positive TRAb when it is drug withdrawal in early pregnancy,relapse rate of hyperthyroidism probability increased after the drug was stopped,which can also cause adverse pregnancy outcomes of maternal and perinatal infant,therefore terminated antithyroid drug(ATD)treatment,it is important to closely monitor the change of maternal thyroid function,reduce the occurrence of adverse pregnancy outcomes.