徐晶 柳林康 谢小琴

【摘要】 目的：回顧性分析妊娠早期甲状腺功能减退症患者的临床资料，探讨该病与妊娠结局及新生儿并发症的相关性。方法：将本院收治的妊娠早期临床甲状腺功能减退的孕妇46例设为观察一组、妊娠早期亚临床甲状腺功能减退的孕妇71例设为观察二组、正常妊娠孕妇55例设为对照组，所有孕妇均在本院产检并分娩。对三组孕妇的临床资料进行回顾性分析，探讨甲状腺功能减退与妊娠结局及新生儿并发症的相关性。结果：观察一组和观察二组自发性流产、早产、胎膜早剥、胎膜早破、产后贫血发生率明显高于对照组（P<0.05），其中观察一组上述指标发生率明显高于观察二组（P<0.05）。观察一组和观察二组新生儿Apgar评分明显低于对照组（P<0.05），观察一组和观察二组新生儿Apgar评分比较差异无统计学意义（P>0.05）。三组新生儿胎儿畸形、死胎比较差异无统计学意义（P>0.05）。观察一组和观察二组低体重儿、巨大儿、先天性甲状腺功能减退、胎儿宫内窘迫及并发症总发生率明显高于对照组（P<0.05），其中观察一组上述指标明显高于观察二组（P<0.05）。结论：妊娠早期甲状腺功能减退可对妊娠结局产生不良影响，并增加新生儿并发症发生率，临床工作中应加强甲状腺功能的孕前及产前筛查，以减少产后妊娠不良结局及新生儿并发症的发生，从而提高母婴安全和实现优生优育。

【关键词】 妊娠早期； 甲状腺功能减退症； 妊娠结局； 新生儿并发症

【Abstract】 Objective：To review the clinical data of the patients with hypothyroidism in the early pregnancy， and to explore the relationship between the disease and the outcome of pregnancy and the complications of the newborn.Method：46 pregnant women with hypothyroidism in early pregnancy treated in our hospital were set up to observation one group and 71 pregnant women with subclinical hypothyroidism in early pregnancy to observation two group and 55 normal pregnant women as control group.All pregnant women were in our hospital for examination and childbirth.The clinical data of three groups of pregnant women were retrospectively analyzed to explore the correlation between hypothyroidism and pregnancy outcome and neonatal complications.

Result：The incidence of spontaneous abortion，premature birth， premature rupture of membranes， premature rupture of membranes， and postpartum anemia in the two groups were significantly higher than that of the control group（P<0.05）.The incidence of the above indexes in observation one group was significantly higher than that in the observation two group（P<0.05）.The Apgar score of two groups of newborns was observed to be significantly lower than that in the control group（P<0.05）. There was no significant difference between the observation one group and the observation two group of newborns with Apgar score（P>0.05）.There was no significant difference in fetal malformation and stillbirth in the three groups（P>0.05）；the total incidence of low weight infants， giant infants， congenital hypothyroidism， fetal distress and complications of observation one group and observation two group were significantly higher than that of the control group（P<0.05）.The above indexes in observation one group were significantly higher than that of observation two group（P<0.05）.Conclusion：Hypothyroidism in the early pregnancy can have adverse effects on pregnancy outcome and increase the incidence of neonatal complications.In clinical work， pre pregnancy and prenatal screening should be strengthened to reduce the adverse outcome of postpartum pregnancy and the occurrence of neonatal complications so as to improve the safety of mothers and infants and to achieve eugenics.

【Key words】 Early pregnancy； Hypothyroidism； Pregnancy outcome； Neonatal complications

First-authors address：Pingxiang Maternal and Child Health Hospital，Pingxiang 337000，China

doi：10.3969/j.issn.1674-4985.2018.31.008

甲状腺功能减退是较为常见的内分泌疾病，也是最多见的妊娠期内分泌疾病之一[1]，据统计该病在妊娠期妇女发生率2%～3%，并呈逐年上升趋势[2]。它可造成孕妇代谢和各系统功能减退，若处理不当可能影响到母体及胎儿的健康，导致不良妊娠结局、影响胎儿神经系统发育[3]。本研究通过回顾性分析妊娠早期甲状腺功能减退孕妇的临床资料，探讨甲状腺功能减退与妊娠结局及新生儿并发症的相关性，旨在为该病的预防、治疗提供参考和借鉴。现报告如下。

1 资料与方法

1.1 一般……