Effects Of Subclinical Hypothyroidism And Its Intervention On Perinatal Outcomes In Pregnancy

Objective:This study analyzed the effects of subclinical hypothyroidism(SCH)and anti-thyroid peroxidase antibody(TPOAb)on perinatal outcomes,observed the clinical efficacy of interventions for subclinical hypothyroidismand and aims to analyze the relationship between subclinical hypothyroidism.during pregnancy as well as its intervention and pregnancy outcomes,to guide the clinical treatment of pregnant women with subclinical hypothyroidism further and reduce the incidence of maternal and fetal diseases,so that the perinatal outcome can be improved.Methods:A total of 835 pregnant women in early pregnancy(6-12 weeks)with SCH who undergone physical examination in Jinan Maternal and Child Health Hospital from July 2016 to June 2017 and had miscarriage or delivery in this hospital were divided into two groups according to the thyroid stimulating hormone(TSH)value:163 pregnant women in group A(TSH 4.0-10.0 mIU/L)and 672 pregnant women in group B(TSH 2.5-4.0 mIU/L).Normal pregnant women(TSH 0.1-2.5 mIU/L)served as control group C.Statistics of pregnant women’s general conditions(age,parity,adverse pregnancy history,educational background,etc.),thyroid function indicators(TSH,FT4 and TPOAb)in early pregnancy,treatment and perinatal outcomes(abortion,premature delivery,GDM,anemia,premature rupture of membranes,hypertensive disorders during pregnancy,placental abruption Postpartum hemorrhage,small gestational age and other information).SPSS 20.0 software was used to analyze the effect of SCH and its treatment on perinatal outcome.Result:1.The relationship between thyroid function and TPOAb:The positive rate of TPOAb was 20.0%(167/835)in SCH pregnant women,30.06%(49/163)in group A,17.56%(118/672)in group B and 6.33%(14/221)in group C.The incidence of TPOAb positive in each group was compared,and the incidence of TPOAb positive in each group was significantlydifferent(P<0.05).2.Effect of SCH on perinatal outcomes:The incidence of anemia,abortion,preterm delivery,hypertensive disorders during pregnancy and infants younger than gestational age in group A and group B were higher than those in group C(P<0.05).3.Relationship between TPOAb and perinatal outcomes:The incidence of abortion,preterm delivery,hypertensive disorders of pregnancy and small gestational age infants was significantly higher in TPOAb positive group than in TPOAb negative group(P<0.05).4.The relationship between SCH intervention therapy and perinatal outcomes:The incidence of anemia,abortion,preterm delivery,GDM,hypertensive disorders of pregnancy and infants with less than gestational age in SCH untreatment group was higher than that in SCH treatment group(P<0.05);5.The relationship between TPOAb positive intervention therapy and perinatal outcomes:The incidence of anemia,abortion,preterm delivery,premature rupture of membranes,GDM,hypertensive disorders of pregnancy,and infants with less than gestational age in SCH combined with TPOAb positive untreatment group was higher than that in treatment group(P<0.05);But when SCH combined with TPOAb negative untreatment group was compared with TPOAb negative treatment group in group B,there was no statistical difference in adverse pregnancy outcomes.Conclusion:1.TPOAb positive is associated with thyroid dysfunction during pregnancy.2.SCH in early pregnancy can increase the incidence of perinatal adverse outcomes such as abortion,premature delivery,hypertensive disorders during pregnancy,anemia and infants younger than gestational age.3.TPOAb positive may have adverse effects on perinatal outcomes.4.For pregnant SCH women,thyroid hormone intervention therapy is protective for perinatal outcomes.5.For pregnant women of SCH combined with TPOAb positive,appropriate thyroid hormone interventions are recommended to reduce the incidence of adverse pregnancy outcomes;for pregnant women of TPOAb negative with TSH 2.5-4.0 mlU/L however,interventions are not necessary.