Study On The Interaction Between Hypothyroidism And Gestational Diabetes

Background and ObjectiveGestational diabetes mellitus(gestational diabetes mellitus,GDM)and hypothyroidism during pregnancy are common obstetrical metabolic diseases.Thyroid hormones play an important role in regulating glucose homeostasis in human body.Hypothyroidism has profound effects on glucose metabolism and insulin secretion.Whether GDM pregnant women are more likely to develop thyroid hormone disorder,this paper aims to study the interaction between the two,and how the impact on pregnant women and fetuses.ObjectiveTo analyze the effects of hypothyroidism on glucose metabolism and renal function of pregnant women,and the effects of gestational diabetes mellitus on thyroid function of pregnant women,and to study the interaction between the two diseases on pregnancy outcome.Materials and methods232 cases of gestational diabetes mellitus with hypothyroidism(group A),268 cases of simple diabetes(group B),and 198 cases of simple hypothyroidism(group C)were selected for admission to our hospital from January 2016 to December 2016..Blood glucose(fasting blood glucose,1 hour postprandial blood glucose,2 hours postprandial blood glucose),renal function(creatinine,urea,cystatin C,uric acid),group A and group C thyroid function in group A and group B(FT4,TSH,TPOAb positive rate),the incidence of adverse outcomes in three groups of pregnant women(premature rupture of membranes,placental abruption,premature delivery,postpartum hemorrhage,macrosomia,gestational anemia,neonatal asphyxia,gestational hypertension).Statistical analysis was carried out by software SPSS21.0.The data conformed to normal distribution and were expressed by mean(sx ±)standard deviation.Single factor analysis of variance was used to compare the three groups of measurement data.T test was used to compare the measurement data between groups,X test was used to compare the counting data between groups,and the test level was ?=0.05.Results(1)General data:There was no significant difference in age(P=0.755)and gestational weeks(P=0.864)among the three groups.(2)There was no significant difference in OGTT 1h between group A and group B(P=0.556).Fasting blood sugar(P=0.014)and OGTT 2h(P=0.000)in group A were significantly higher than those in group B,and the difference was statistically significant(3)There was no significant difference in cystatin C(P=0.082)and uric acid(P=0.609)between the two groups.Compared with creatinine and urea,creatinine(P=0.002)and urea(P=0.001)in group A were significantly higher than those in group B,with statistical significance.(4)There was no significant difference in FT4 between group A and group C(P=0.605),but TSH in group A was significantly higher than that in group C(P=0.031).The positive rate of TPOAb in group A was significantly higher than that in group C(P=0.011).(5)The total incidence of adverse pregnancy outcomes in group A was significantly higher than that in group B(P=0.000).There were significant differences between group A and group B in the incidence of premature birth(P=0.011),macrosomia(P=0.043)and pregnancy anemia(P=0.042).There were no significant differences in premature rupture of membranes(P=0.853),placental abruption(P=0.267),postpartum hemorrhage(P=0.589),neonatal asphyxia(P=0.110)and gestational hypertension(P=0.800)between the two groups.(6)Compared with the overall adverse pregnancy outcomes,the total incidence of adverse pregnancy outcomes in group A was significantly higher than that in group C(P=0.001).There were significant differences in the incidence of premature rupture of membranes(P=0.033)and macrosomia(P=0.043)between group A and group C.There were no significant differences in placental abruption(P=0.577),premature delivery(P=0.726),postpartum hemorrhage(P=0.945),pregnancy anemia(P=0.269),neonatal asphyxia(P=0.338),pregnancy hypertension(P=0.968)between the two groups.ConclusionConclusion: Compared with pregnant women with simple gestational diabetes or simple hypothyroidism,the incidence of adverse pregnancy outcomes in pregnant women with gestational diabetes mellitus and hypothyroidism increased.