Analysis Of Related Influencing Factors And Adverse Pregnancy Outcome Of Pregnancy Complicated With Hypothyroidism

Objective This study through the collection and analysis of pregnancy with hypothyroidism medical records and the related clinical data,surrounding the pregnancy with hypothyroidism aderse outcome,mother and son relationship is discussed,and further pregnancy with hypothyroidism some related influencing factors,in order to guide the pregnancy with hypothyroidism of pregnancy management provides the basis,To reduce the risk of maternal and infant,improve perinatal adverse outcomes to provide direction.Methods From September 2019 to February 2021,pregnant women with thyroid function screening in the early pregnancy were retrospectively analyzed.According to the thyroid function indicators in the early pregnancy(within 14 weeks of gestation),255 pregnant women with hypothyroidism were collected.And collected in the same time period of normal thyroid function of 240 pregnant women as the control group.The general data,thyroid function,serological indicators of early and middle pregnancy,standardized treatment of oraleuthyroxine,pregnancy complications and complications,delivery mode,delivery complications and neonatal status of all pregnant women who met the inclusion criteria were collected in detail.All the collected clinical data and serological examination results of different periods were input into Excel and classified and coded.SPSS 26.0 data processing software was used for data statistics and analysis.In order to further clarify the influencing factors of pregnancy with hypothyroidism,multi-factor Logistic regression analysis was conducted to summarize and analyze the risk factors of pregnancy with hypothyroidism.Results(1)The comparison results between normal thyroid function group and hypothyroidism group were as follows: the ratio of age > 30 years old in normal group,the ratio of pre-pregnancy BMI > 24 kg/m2,the ratio of parturient women,the ratio of adverse pregnancy history and the ratio of no regular prenatal examination were lower than that in hypothyroidism group(P < 0.05);The levels of free thyroxine(FT4),hemoglobin(HB),erythrocyte specific volume(HCT)and serum ferritin(SF)in normal pregnancy group were significantly higher than those in hypothyroidism group.Thyroid stimulating hormone(TSH),thyroid peroxidase antibody(TPOAB),platelet(PLT),alanine aminotransferase(ALT),serum creatinine(Scr)and cystatin C(Cys-C)in hypothyroidism group were significantly lower than those in hypothyroidism group(P < 0.05);SF,HB,HCT,total protein and albumin in normal group were significantly higher than those in hypothyroidism group,AST,ALT,TBil,triglyceride(TG),low density lipoprotein(LDL),serum uric acid(UA)and Cys-C in normal group were significantly lower than those in hypothyroidism group(P < 0.05).The rates of hypertensive disease,GDM,premature rupture of membranes,cesarean section,neonatal asphyxia and neonatal abnormality in normal group were significantly lower than those in hypothyroidism group(P < 0.05).(2)The rates of hypertensive disease,GDM,premature rupture of membranes,cesarean section and neonatal abnormality in the treatment group were significantly higher than those in the treatment group(P < 0.05).(3)The incidence of GDM in pregnant women with hypothyroidism accompanied by TPOAB(+)was higher than that in pregnant women with hypothyroidism accompanied by TPOAB(-)(P <0.05).(4)Age > 30 years,primipara in this pregnancy,increased BMI before pregnancy,low SF level,high TPOAB(+)level and low protein level in early pregnancy were independent risk factors for pregnancy with hypothyroidism(P < 0.05).Conclusion The incidence of maternal and infant adverse outcomes(such as hypertension during pregnancy,GDM,premature rupture of membranes,natural delivery rate,neonatal asphyxia and neonatal abnormalities)was significantly higher in patients with hypothyroidism during pregnancy.Pregnant women with hypothyroidism accompanied by TPOAB(+)are more likely to develop GDM during pregnancy than pregnant women accompanied by TPOAB(-).Therefore,pregnant women with hypothyroidism accompanied by TPOAB(+)should pay attention to blood glucose during pregnancy and be alert to the occurrence of GDM.Advanced maternal age,primary parturient pregnancy,increased BMI before pregnancy,low serum SF level in early pregnancy,high concentration of TPOAB(+)and low protein level were independent risk factors for hypothyroidism during pregnancy.Therefore,education and prenatal examination should be strengthened for pregnant women with high risk factors of hypothyroidism during pregnancy.Routine screening of thyroid function in early pregnancy is recommended,especially for patients with hypothyroidism,it is necessary to increase SF detection.And reasonable guidance of nutrition during pregnancy,especially iron supplementation,reduce pregnancy complications and maternal and infant risk.