Thyroid Specific Reference Values In The First And Second Trimester And Analysis Of Thyroid Function

Objective:1.To establish the normal reference range of specific serum thyroid test index of pregnant women in the first and second trimester.2.The prevalence of thyroid disease was compared by pregnancy specific reference index and non-pregnancy population.3.Screening of thyroid peroxidase antibody?TPOAb?positive and negative thyroid disease prevalence in the first and second trimester.4.To investigate the relationship between subclinical thyroid dysfunction and pregnancy complications.method:A total of 1203 pregnant women with complete thyroid function tests from June2016 to November 2017 in Gynecological Pregnancy Hospital of Santan Hospital,Nankai District,Tianjin City,The indexes include:thyroid stimulating hormone?TSH?,free thyroxine?FT4?and thyroid peroxidase antibody?TPOAb?,excluding assisted reproductive technology pregnancy,twin pregnant women and thyroid function Abnormal 55 people,The remaining 1,148 pregnant women were enrolled in group A,and 896 pregnant women were selected as group B after screening for pregnancy-induced hypertension,gestational diabetes mellitus,anemia,preeclampsia and TPOAb-According to the gestational weeks early pregnancy T1(8¹2⁺⁶ weeks)and the second trimester T2(13²7⁺⁶ weeks),Select the same period physical examination 150 pregnant women as a normal control.the use of SPSS22.0 software,using the percentile 95%CI method to establish early pregnancy specific serum thyroid Test indicators of the normal reference range.Evaluation of thyroid function in pregnant women in group A according to established pregnancy specific reference range and non-pregnancy population reference range The prevalence of thyroid peroxidase antibody?TPOAb?positive and negative thyroid diseases rate.A total of637 normal cases with complete information,15 subclinical cases with subclinical reduction,19 cases with hypoT4emia and 79 cases with simple TPOAb positive were studied.result:1.The specific reference range of thyroid function in early pregnancy of this unit:T1:TSH 1.25?0.03³.82?mIU/L and FT4 13.60?10.95¹7.55?pmol/L;T2:TSH1.73?0.05⁴.51?mIU/L and FT4 11.66?9.16¹5.62?pmol/L.2.According to the specific reference value during pregnancy,the total prevalence of thyroid disease during pregnancy was 9.8%?112/1148?,of which 27cases were hypothyroidism?clinical hypothyroidism in 4 cases and subclinical hypothyroidism in 23 cases?24 cases of hyperthyroidism?clinical hyperthyroidism in12 cases,12 cases of subclinical hyperthyroidism?,hypothyroidism?T4?in 61 cases of hyperlipidemia.According to the reference value of non-pregnant population,the total prevalence of thyroid disease was 12.7%?146/1148?,of which 16 cases were hypothyroidism?clinical hypothyroidism in 3 cases,subclinical hypothyroidism in 13cases?,hyperthyroidism in 117 cases?clinical hyperthyroidism 14 cases,103 cases of subclinical hyperthyroidism?,13 cases of low T4 hyperlipidemia.3.The total prevalence of thyroid in T1 was 9.3%?66/709?,of which clinical hypothyroidism was 0.4%?3/709?,subclinical hypothyroidism was 2.0%?14/709?,clinical hyperthyroidism was 1.0%?7/709?,Subclinical hyperthyroidism was 1.1%?8/709?,and hypokalemia was 4.8%?34/709?.4.The total prevalence of thyroid in stage T2 was 10.5%?46/439?,of which clinical hypothyroidism was 0.2%?1/439?,subclinical hypothyroidism was 2.1%?9/439?,and clinical hyperthyroidism was 1.1%?5/439?,Subclinical hyperthyroidism0.9%?4/439?,and low T4 hyperlipidemia 6.2%?27/439?.5.The positive rate of TPOAb was 10.9%?125/1148?.The positive rate of TPOAb was 10.9%?77/709?in T1 and 9.9%?70/709?in TPOAb alone.The positive rate of TPOAb was 10.9%?48/439?,Only TPOAb-positive 9.6%?42/439?.6.The prevalence of clinical hypothyroidism in TPOAb-positive pregnant women was 1.6%?2/125?,subclinical hypothyroidism was 1.6%?2/125?,clinical hyperthyroidism was 1.6%?2/125?,subclinical hyperthyroidism was 0.8%?1/125?,low blood T4 4.0%?5/125?.The prevalence of TPOAb-negative pregnant women was0.2%,2.1%,1.0%,1.1%,5.5%respectively.7.There was a significant negative correlation between FT4 and TSH in T1 and T2,negative correlation between FT4 in T2 and age,and negative correlation between TSH and birth time.8.Subclinical hypothyroidism?Simple TPOAb-positive and hypo-T4hyperlipidemia have increased the risk of pregnancy complications.Conclusion:A series of changes in maternal thyroid hormone levels at all stages of pregnancy,influenced by a variety of factors,made it necessary to establish a range of reference values for pregnancy specific thyroid function indicators.Studies have found a high incidence of subclinical hypothyroidism,low T4 blood syndrome and simple TPOAb positive in the first trimester.Early screening has helped to detect early treatment and further prevent the risk of complications and adverse pregnancy outcomes.