Effect Of Pregnancy-induced Hypothyroxinemia On Maternal And Infant

Objective:By retrospectively collecting the obstetrics and delivery data of 2,000pregnant women in our hospital,the effect of pregnancy-induced hypothyroxinemia on maternal laboratory examination indicators and maternal and child complications was studied,and the theory of targeted treatment for such patients was improved Basis to increase the importance of obstetricians and pregnant women in the screening and follow-up of thyroid function,so as to achieve early detection,early diagnosis and early treatment of diseases,thereby improving the quality of the birth population.Methods:By reviewing our hospital medical record browser,retrospectively collected data on pregnant women who were delivered in the obstetrics inpatient department of our hospital from November 2018 to December 2019,including birth checkup data(age,body mass index,gestational week for the first birth check,and birth history Laboratory examination data,etc.)and delivery information(complications during pregnancy,the results of the last ultrasound examination,complications during delivery,delivery methods,and neonatal-related data).According to the inclusion and exclusion criteria,2000 eligible pregnant women were grouped according to thyroid function,blood FT4 levels,and whether TPOAb was positive,and compare the differences between indicators.All the collected data were analyzed by SPSS22.0statistical software.To explore the effects of gestational hypothyroxinemia during pregnancy on pregnancy complications,delivery methods,complications during delivery,and the basic situation of the fetus and newborn,and analyze the relevant factors that affect the pregnancy.Results:1.The distribution of thyroid function in 2000 pregnant women's first birth examination:Among the 2000 pregnant women,96 cases of hypothyroidism during pregnancy,accounting for 4.8%;1351 cases of normal thyroid function during pregnancy,accounting for 67.55%.2.Comparison of various indexes of pregnant women in hypothyroxinemia group(HT group)and the normal thyroid function group:In general,the pregnant women in the HT group had the first pregnancy gestational age and were older than the normal thyroid function group,the difference was statistically significant(P<0.01).In terms of fertility history,the incidence of spontaneous abortion in pregnant women in the HT group was greater than the incidence of spontaneous abortion in pregnant women in the normal thyroid function group(P<0.05).In terms of the results of the first obstetric laboratory test,the WBC,neutrophil percentage,TC,TG,and TPOAb of pregnant women in the HT group were greater than those in the normal thyroid function group,and the difference was statistically significant(P<0.05,P<0.01).The percentage of lymphocytes,HGB,white/globules,blood glucose,creatinine,serum ferritin,FT3 and FT4 in the HT group were less than those in the normal thyroid function group.The difference was statistically significant(P<0.05,P<0.01).The TSH of pregnant women in the HT group was lower than that of the normal thyroid function group,but the difference was not statistically significant(P=0.754).In terms of OGTT results,the fasting blood glucose,blood glucose at 1h and 2h postprandial blood glucose of pregnant women in the HT group were greater than those in the normal thyroid function group(P<0.05,P<0.01).In terms of adverse pregnancy outcomes,the incidence of gestational diabetes and premature delivery in pregnant women in the HT group was significantly greater than that of normal thyroid function group,and the difference was statistically significant(P=0.000,P<0.05).There was no statistically significant difference in other adverse pregnancy outcomes between the two groups.In terms of general conditions at delivery,the gestational age of pregnant women in the HT group was less than that in the normal thyroid function group,and the difference was statistically significant(P<0.05).The BMI of the pregnant women in the HT group was higher than that in the normal thyroid function group,and the difference was statistically significant(P=0.000).There was no statistically significant difference between the two groups in the results of the last ultrasound and the general condition of the newborn.3.Comparison of pregnant women with isolated hypothyroxinemia group(IH group)and normal thyroid function group:In terms of adverse pregnancy outcomes,the incidence of gestational diabetes and placental abruption in pregnant women in the IH group was greater than that in the normal thyroid function group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in other adverse pregnancy outcomes between the two groups.In terms of general conditions of pregnant women and newborns,the age of pregnant women in the IH group were greater than those in the normal thyroid function group,and the difference was statistically significant(P=0.000).The birth weight of the pregnant women in group IH was lower than that in normal thyroid function group(P=0.000),and the difference was statistically significant.There was no statistically significant difference between the two groups in the results of the last ultrasound and the other general condition of the newborn.4.FT4 level was negatively correlated with age,BMI before delivery,fasting blood glucose and blood glucose at 2 hours after meal(r=-0.049,P=0.005;r=-0.138,P=0.014;r=-0.327,P=0.027,R=-0.411,P=0.006).5.The FT4 level,age,and BMI before delivery were included as independent variables in multivariate logistic regression analysis,which showed that HT,age?35,and BMI before delivery(kg/m~2)?25 were the risks of gestational diabetes and premature delivery.factor.Conclusion:1.The incidence of hypothyroxinemia during pregnancy is high and should be taken seriously by obstetricians.Hypothyroxinemia during pregnancy will increase the risk of maternal adverse pregnancy outcomes and also have a certain effect on liver and kidney function.2.Isolated hypothyroxinemia during pregnancy can cause varying degrees of impact on pregnant women and fetuses.3.The level of FT4 is negatively correlated with age,BMI before delivery,fasting blood glucose and 2h blood glucose after a meal,which has certain guiding significance for judging the severity of hypothyroxinemia during pregnancy.4.HT,age?35,BMI before delivery(kg/m~2)?25 are all risk factors for gestational diabetes and premature delivery,which can provide a basis for early intervention.