谭　娟　张璟璐　顾　莹　夏　飞.江苏省连云港市妇幼保健院生殖遗传科，江苏连云港　22200；2.苏州大学附属第一医院生殖中心，江苏苏州　25006

妊娠期甲状腺功能减退症对妊娠结局的影响

谭娟1张璟璐1顾莹1夏飞2▲1.江苏省连云港市妇幼保健院生殖遗传科，江苏连云港222001；2.苏州大学附属第一医院生殖中心，江苏苏州215006

目的探讨妊娠期甲状腺功能减退症对妊娠结局的影响。 方法对2013年6月1日～2014年5月31日期间在连云港市妇幼保健医院产科门诊产检6962例P妇进行甲状腺功能筛查，选择患妊娠期甲状腺功能减退症的282例P妇作为试验组，试验组予药物治疗，随机选择甲状腺功能正常的P妇共300例作为正常对照组，观察两组P妇的妊娠结局。结果早P期治疗组自然流产发生率高于正常对照组（P＜0.05）；中晚P期治疗组妊娠期高血压疾病、早产发生率高于对照组及早P期接受治疗组（P＜0.05）；未治疗组研究对象早产、胎盘早剥及胎儿生长受限（FGR）的发生率高于对照组及早P期治疗组（P＜0.05）。结论妊娠期甲减对妊娠及其结局有许多负面影响，会增加自然流产、早产、FGR、妊娠期高血压疾病的发生率；通过及时、适当的治疗，可降低不良妊娠的发生率。

妊娠期；甲减；TSH；妊娠结局

［Abstract］Objective To discuss the gestational hypothyroidism on pregnancy outcome.M ethods Thyroid function screening was taken for 6962 pregnantwomen who were served with prenatal care in Lianyungang Maternal and Child Health Hospital from 2013 June 1 to 2014 May 31.282 women with hypothyroidism during pregnancy were found，who treated with drugswere selected as treatment group 300 normal thyroid function women were randomly selected as control group.The pregnancy outcome was recorded in two groups.Results The incidence of spontaneous abortion in early pregnancy treated group was higher than that in control group，with statistically significant difference（P＜0.05）.The incidence of gestational hypertension，premature birth in late pregnancy treated group were higher than that in control group and early pregnancy treated group，with statistically significant difference（P＜0.05）.The incidence of preterm delivery，placental abruption and fetal growth restriction in untreated group were all higher than those in control group and early pregnancy treated group，with statistically significant difference（P＜0.05）.Conclusion The gestational hypothyroidism has negatively affect on the pregnancy and its outcome，and can increase the incidence of spontaneous abortion，premature birth，FGR，and gestational hypertension.Timely and appropriate treatment can reduce the incidence of adverse pregnancy.

［Key words］Pregnancy；Hypothyroidism；TSH；Pregnancy outcomes

甲状腺功能减退症（以下简称甲减）是由于甲状腺激素合成及分泌减少，或者其生理效应不足导致机体代谢降低的一种疾病。甲状腺激素是人体生长发育所必需的一类激素，几乎作用于机体所有的组织及器官，对代谢、生长、发育、生殖等功能均有重要影响。……