孕早期亚临床甲状腺功能减退及年龄与早产的相关性研究

doi:10.11852/zgetbjzz2019-01771

中国儿童保健杂志 ›› 2020, Vol. 28 ›› Issue (3): 247-251.DOI: 10.11852/zgetbjzz2019-01771

孕早期亚临床甲状腺功能减退及年龄与早产的相关性研究

邵亚雯, 白岩, 蔺茹, 陈玛丽, 何文华, 赵有红

甘肃省妇幼保健院,甘肃兰州 730050

收稿日期:2019-02-19 发布日期:2020-03-10 出版日期:2020-03-10
通讯作者: 赵有红,E-mail:316291706@qq.com
作者简介:邵亚雯(1984-),女,甘肃人,主治医师,主要研究方向为妇幼卫生保健。
基金资助:
甘肃省自然科学基金项目(17JR5RA026);中疾控妇幼中心合生元母婴营养与健康研究项目(2018FYH007)

Study on the correlation of preterm birth with subclinical hypothyroidism and age of pregnant women

SHAO Ya-wen, BAI Yan, LIN Ru, CHEN Ma-li, HE Wen-hua, ZHAO You-hong

Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu 730050, China

Received:2019-02-19 Online:2020-03-10 Published:2020-03-10
Contact: ZHAO You-hong, E-mail: 316291706@qq.com

摘要/Abstract

摘要： 目的分析年龄及孕早期亚临床甲减(SCH)与早产及其亚型的相关性,为不同年龄孕早期亚甲减患者孕期监测制定个体化策略提供科学依据。方法以2016年2月-2018年6月在甘肃省妇幼保健院高危产科产检的单胎活产孕妇2 868例为研究对象,使用Logistic回归模型分别分析年龄及孕早期亚甲减与早产的相关性。结果控制混杂因素后,与适龄孕妇相比,高龄孕妇(≥35岁)发生早产风险增加0.67倍(OR=1.67,95%CI:1.32~2.13);年龄较小孕妇发生早期/极早期早产风险升高2.65倍(OR=3.65,95%CI:2.21~6.05)。与甲功正常孕妇相比,亚甲减孕妇发生早产风险增加2.07倍(OR=3.07,95%CI:2.28~4.12)、发生中晚期早产风险增加1.67倍(OR=2.67,95%CI:1.86~3.83)。交互作用分析显示,年龄与亚临床甲减对早产的发生风险存在相乘的交互作用。结论不同年龄亚甲减孕妇发生早产及其亚型的风险不一致。建议对孕早期亚甲减患者应根据年龄进行风险分层,开展个体化孕期管理和用药指导。

关键词: 亚临床甲状腺功能减退, 过氧化物酶抗体, 早产, 高龄孕妇

Abstract: Objective To investigate the association of preterm birth with pregnant women age and subclinical hypothyroidism (SCH), in order to provide scientific evidence for making individualized strategies for pregnant women with SCH. Methods A total of 2 868 pregnant women in Gansu Provincial Maternity and Child Care Hospital were enrolled in this study from February 2016 and June 2018. Unconditional Logistic regression model was used to evaluate the associations between age, SCH and the risk of preterm birth. Results Compared with moderate age women, women of advanced reproductive age had higher risk of preterm birth (OR=1.67,95%CI: 1.32-2.13). Younger women had higher risk for very preterm birth (OR=3.65, 95%CI: 2.21-6.05).Compared with women with normal thyroid function, women with SCH had higher risk of preterm birth and moderate preterm birth (preterm birth,OR=3.07, 95%CI:2.28-4.12; moderate preterm birth OR=2.67, 95%CI:1.86-3.83).Interaction analysis revealed a multiplier interaction between age and SCH on the risk of preterm birth. Conclusions The risk of preterm birth and its subtypes in SCH patients of different ages is not consistent. It is suggested to assess preterm risk in SCH women by different age groups and take individualized pregnancy management and medication guidance.

Key words: subclinical hypothyroidism, thyroid peroxidase antibody, preterm birth, women of advanced reproductive age

中图分类号:

R714.2

邵亚雯, 白岩, 蔺茹, 陈玛丽, 何文华, 赵有红. 孕早期亚临床甲状腺功能减退及年龄与早产的相关性研究[J]. 中国儿童保健杂志, 2020, 28(3): 247-251.

SHAO Ya-wen, BAI Yan, LIN Ru, CHEN Ma-li, HE Wen-hua, ZHAO You-hong. Study on the correlation of preterm birth with subclinical hypothyroidism and age of pregnant women[J]. Chinese Journal of Child Health Care, 2020, 28(3): 247-251.

参考文献

[1] Moster D, Lie RT, Markestad T. Long-term medical and social consequences of preterm birth[J]. N Engl J Med, 2008, 359(3): 262-273.
[2] Rm S, Dw B. Cervical pessary to prevent preterm birth[J]. JAMA, 2017, 318(23): 2299-2300.
[3] Liu L,Johnson HL,Cousens S,et al. Global, regional, and national causes of child mortality: an updated systematic analysisi for 2010 with time trends since 2000[J]. Lancet, 2012, 379(9832): 2151-2161.
[4] 莫莺健, 王长智. 早产相关因素研究进展[J]. 汕头大学医学院学报, 2017, 30(1): 62-64.
[5] Negro R, Mestman JH. Thyroid disease in pregnancy[J].Best Pract Res Clin Endocrinol Metab, 2011, 25: 927-943.
[6] Blazer S, Moreh-Waterman Y, Miller-Lotan R,et al. Maternal hypothyroidismmay affect fetal growth and thyroid function[J]. Obstel Gynecol, 2003, 102(2): 232-241.
[7] 尹玲凤, 丁虹娟. 早产相关因素的临床分析[J]. 中国妇幼健康研究, 2016, 27(10): 1234-1237.
[8] Casey BM, Dashe JS, Wells CE,et al. Subclinical hypothyroidism and pregnancy outcomes[J]. Obstel Gynecol, 2005, 105(2): 239-245.
[9] 王红琴. 妊娠合并甲状腺功能减退的筛查及转归[J]. 中国妇幼保健, 2015, 30(16): 2511-2513.
[10] Green AS, Abalovich M, Alexander E, et al. Guidelines of the American Thyroid Association for the diagnosis and management of thyroid disease during pregnancy and postpartum[J]. Thyroid, 2011, 21(10): 1081-1125.
[11] Howson CP, Kinney MV, McDougall L. Born too soon: preterm birth matters[J]. Repord Health, 2013, 10(Suppl 1): S1.
[12] Xu H, Dai Q, Xu Y, et al. Time trends and risk factor associated with premature birth and infants deaths due to prematurity in Hubei Province, China from 2001 to 2012[J]. BMC Pregnancy Childbirth, 2015, 15:329.
[13] Mwaniki MK, Atieno M, Lawn JE, et al. Long-term neurodevelopmental outcomes after intrauterine and neonatal insults: a systematic reveiw[J]. Lancet, 2012, 379(9814): 445-452.
[14] Newnham JP, Dickinson JE, Hart RJ, et al. Strategies to prevent preterm birth[J]. Front Immunol, 2014, 5:584.
[15] Abalovich M, Gutierrez S, Alcaraz G, et al. Overt and subclinical hypothyroidism complicating pregnancy[J]. Thyroid, 2002, 12(1):63-68.
[16] Casey BM, Dashe JS, Wells CE,et al. Subclinical hypothyroidism and pregnnacy outcomes[J]. Obstet Gynecol, 2005, 105(2): 239-245.
[17] Schneuer FJ, Nassar N, Tasevski V, et al. Association and predcitve accuracy of high TSH serum levels in first trimester and advese pregnnacy outcomes[J]. J Clin Endocrinol Metab, 2012, 97(9): 3115-3122.
[18] Tong Z, Xiaowen Z, Baomin C, et al. The effect of subclinical maternal thyroid dysfunction and autommunity on intrauterine growth restriction[J]. Medicine (Baltimore), 2016, 95(19): e3677.
[19] Brits H, Adriaanse M, Rall DM, et al. Causes of prematuirty in the bloemfontein academic complex[J]. S Afr Fam Pract, 2015, 58(3): 223-226.
[20] Oakley L, Penn N, Pipi M, et al. Risk of adverse obstetic and neonatal outcomes by maternal age:quantifying individual and population level risk using routine UK maternity data[J]. PLoS One, 2016, 11(10): e0164462.
[21] Barber KJ, Franklyn JA, McCabe CJ,et al. The in virto effects of triiodothyronine on epidermal growth foctor-induced trophoblast function[J]. J Clin Endocrinol Metab, 2005, 90(3): 1655-1661.

孕早期亚临床甲状腺功能减退及年龄与早产的相关性研究

Study on the correlation of preterm birth with subclinical hypothyroidism and age of pregnant women

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	张丹, 张军, 杨钰荣, 曹咪, 闫敬敏, 朱璐阳. 肠道菌群与早产儿脑发育及神经认知行为关系的研究[J]. 中国儿童保健杂志, 2023, 31(7): 756-759.
[2]	冯骁, 陈凌, 赵红缨, 黄蕊, 林辰曦, 庄丽娟. 不同脐带挤压方式对极早产儿结局的影响[J]. 中国儿童保健杂志, 2023, 31(7): 794-798.
[3]	郑亭玉, 张春宇, 杨飞, 郑芳, 张梦霞, 夏露萍, 徐孙超. 营养支持小组管理模式对早产儿生长发育及免疫功能的影响[J]. 中国儿童保健杂志, 2023, 31(5): 555-558.
[4]	夏正龙, 宋燕燕. 支气管肺发育不良早产儿神经发育研究[J]. 中国儿童保健杂志, 2023, 31(4): 390-394.
[5]	李静兰, 孙文强, 朱雪萍. 早产儿支气管肺发育不良相关预测模型研究[J]. 中国儿童保健杂志, 2023, 31(4): 395-398.
[6]	王娜, 李晓莺. 早产儿神经发育评估的进展[J]. 中国儿童保健杂志, 2023, 31(4): 404-407.
[7]	任力, 黑明燕, 齐宇洁, 靳绯, 翁景文, 董世霄, 沈艳华, 姜敏. 早产儿喂养对坏死性小肠结肠炎发病的影响[J]. 中国儿童保健杂志, 2023, 31(4): 438-441.
[8]	陈峰, 张宇. 多胞胎和单胞胎早产儿神经发育的回顾性研究[J]. 中国儿童保健杂志, 2023, 31(4): 451-456.
[9]	王晶, 项思嘉, 鲁莹, 杨蕾, 胡小沙, 钱君, 池霞, 张敏. 早产儿3周岁体格生长及体成分分析[J]. 中国儿童保健杂志, 2023, 31(4): 457-460.
[10]	郑水英, 罗艳赟. 早产儿喂养不耐受的临床表现及相关影响因素[J]. 中国儿童保健杂志, 2023, 31(4): 461-464.
[11]	曹冰冰, 林多华, 杜佩珍, 颜陶, 程建婷. 多种实验室指标和炎性因子表达水平与新生儿神经发育的相关性研究[J]. 中国儿童保健杂志, 2023, 31(2): 205-209.
[12]	何小颖, 吴翠玲, 曾玲艳, 綦美姣, 孙亚莲. 早产儿食物转换对血清营养素水平的影响[J]. 中国儿童保健杂志, 2023, 31(1): 81-85.
[13]	王慧冉, 罗荣, 胡文玲. 2019年3所妇幼保健院早产儿视网膜病变筛查及随访分析[J]. 中国儿童保健杂志, 2023, 31(1): 105-108.
[14]	孙兴, 胡晓山, 刘凤, 刘蓓蓓. 早产儿喂养不耐受的临床特征及影响因素分析[J]. 中国儿童保健杂志, 2023, 31(1): 109-112.
[15]	和娇吉, 刘孝美, 唐孟言, 罗红, 杨速飞, 彭文涛. 基于AIMS分析早产儿运动发育现状及影响因素[J]. 中国儿童保健杂志, 2022, 30(7): 779-782.