Correlation Between The Risk For Hypertension Disorder Complicating Pregnancy And Thyroid Function In Pregnant With Hypothyroidism

OBJECTIVES:To access clinical correlation between the risk for hypertension disorder complicating pregnancy and thyroid function in pregnant women with hypothyroidism.METHODS:Using retrospective analysis,a total of 1776 singleton pregnant women with hypothyroidism,whose prenatal care and delivering in IPMCH from January 1^st2013 to December 31^st 2014,were selected and grouped into improving,worsening and remaining by thyroid function in the first and third trimester.Those who have got hypertension,thyroid diseases,serious other system diseases have been excluded.They were respectively grouped into Subclinical Hypothyroidism and Clinical Hypothyroidism.The incidence of gestational hypertension and preeclampsia were analyzed between groups above.RESULTS:There are 1776 pregnant women in our group,whose average age is29.3±3.3years,and average BMI is 21.7±2.8Kg/m².Among them,the incidence of gestational hypertension is 6.42%,and 1.97%for preeclampsia,0.96%for severe preeclampsia.There are 1469 pregnant women in group improving?include 174 for clinical hypothyroidism and 1295 for subclinical hypothyroidism?,133 for worsening?include 5 for clinical hypothyroidism and 128 for subclinical hypothyroidism?,174 for remaining?include 19 for clinical hypothyroidism and 155for subclinical hypothyroidism?.Since the limited number of clinical hypothyroidism,they are not analyzed.No siginificant differences were found in age,garida,para and the gestational weeks for thyroid function tests.BMI of group worsening were observed significantly higher than group improving and remaining.The incidence of gestational hypertension:group improving 5.17%?76?,worsening 15.04%?20?and remaining 10.34%?18?;The incidence of preeclampsia:group improving 1.29%?19?,worsening 7.52%?10?and remaining 3.45%?6?;The incidence of severe preeclampsia:group improving 0.41%?6?,worsening 6.02%?8?and remaining 1.72%?3?.Significantly higher incidence of gestational hypertension,preelampsia,and especially severe preeclampsia,were observed in group worsening than remaining and improving?P<0.05?.No significantly differences were found in the incidence of mild preeclampsia between those groups?P<0.05?.Using logistic analyze,it is found that the risk for gestational hypertension and severe preeclampsia in group worsening and remaining have no significantly differences,while group improving have lower risk for GH?OR=0.455,95%CI 0.264 0.787?and s PE?OR=0.233,95%CI 0.057 0.946?than group remaining.Among subclinical hypothyroidism,the similar result is found.The incidence of gestational hypertension:group SCH improving 4.94%?64?,SCH worsening 14.84%?19?and SCH remaining 10.32%?16?;The incidence of preeclampsia:group SCH improving 1.24%?16?,SCH worsening 1.7.81%?10?and SCH remaining 3.23%?5?;The incidence of severe preeclampsia:group SCH improving0.46%?6?,SCH worsening 6.25%?8?and remaining 1.94%?3?.Significantly higher incidence of gestational hypertension,preelampsia,and especially severe preeclampsia,were observed in group worsening than remaining and improving?P=0.000?.No significantly differences were found in the incidence of mild preeclampsia between those groups?P<0.05?.Using logistic analyze,it is found that the risk for gestational hypertension and severe preeclampsia in group worsening and remaining have no significantly differences,while group improving have lower risk for GH?OR=0.411,95%CI 0.229 0.738?and s PE?OR=0.214,95%CI 0.052 0.873?CONCLUSIONS:The risk for hypertension disorder complicating pregnancy,especially severe preeclampsia,might be reduced by improving thyroid function in pregnant women with hypothyroidism,including subclinical hypothyroidism.