Analysis Of Pregnancy Sub-acutana,Simple TPOAb Positive-related Factors And Its Effect On Pregnancy Outcomes

Objective: To understand the occurrence status and related factors of hypothyroidism(SCH)and pure thyroid peroxidase(TPOAb)in a hospital of Zibo City,and to explore the effects of pregnancy SCH and simple TPOAb positive on pregnancy outcomes.Methods: Using the Electronic Medical Record System system,7,033 pregnant women were admitted to a hospital in Zibo City from January 2017 to December 2018.According to the diagnostic criteria recommended in the 2018 Guidelines for the Diagnosis and Treatment of Thyroid Diseases during Pregnancy and Postpartum(2018 Revision)(TSH >4.0m IU/L,FT4 Normal/TSH2.5-4.0m IU/ L,TPOAb positive),screening out the requirements of pregnancy SCH pregnant women 336 cases for Group A,pure TPOAb positive pregnant women 426 cases for Group B,and selected the thyroid function of normal and TPOAb negative pregnant women 4798 cases as a control group.Reviewed the incidence of adverse pregnancy outcomes such as gestational hypertension and gestational diabetes in each group,the comparative analysis of group A and control group,Group B and control group related factors such as age,pre-pregnancy BMI,and educational level.Results: 1.The results of a single-factor analysis of pregnancy SCH-related factors showed that age,gravidity were related to the occurrence of SCH(P<0.05).Unconditional logistic regression analysis shows: Compared with pregnant women between the ages of 20 and 25,the age of 31~45 years old women has a risk of developing SCH of 1.643(OR=1.643,95%Cl: 1.188~2.270)times;Pregnant women with gestation times ? 2 compared with pregnant women with gestation times = 0,the risk of pregnancy SCH is 1.776(OR=1.776,95% Cl: 1.136 2.777)times,which was statistically significant(P<0.05).2.The results of single-factor analysis of simple TPOAb positive-related factors show that age,education,pregnancy and the occurrence of simple TPOAb positive are related(P<0.05).Unconditional logistic regression analysis shows: Compared with pregnant women aged 20 to 25 years,pregnant women aged 31~45 years old had a 1.84 times the risk of developing positive TPOAb(OR=1.884,95%Cl: 1.407~2.552)times;Pregnant women with gestation times ? 2 compared to pregnant women with gestation times = 0,the risk of pure TPOAb positive was 2.316(OR = 2.316,95% Cl: 1.526~3.514)times;Compared with pregnant women with pregnancy times=1,the risk of simple TPOAb positive was 1.823(OR=1.823,95%Cl: 1.450~2.293)times,which was statistically significant(P<0.05).3.Compared to pregnant women in the control group,women who developed SCH during pregnancy had a highter incidence of gestational diabetes mellitus(21.73%),anemia(12.20%),premature rupture of membrane(19.35%),Low birth weight(5.65%),fetal distress(12.80%),the difference is statistically significant(P<0.05),and the incidence of poor pregnancy outcomes was significantly higher than that of pregnant women in the control group(P<0.05).After adjustment for potential confounding factors such as age,the logistic regression model was used to find that pregnant women with SCH increased the risk of gestational diabetes mellitus(OR=1.471,95%Cl :1.116~1.940),anemia(OR=1.653,95%Cl :1.156~ 2.363),Low birth weight(OR=2.009,95%Cl : 1.196~3.376),fetal distress(OR=2.288,95%Cl : 1.606~3.261),and the risk of adverse pregnancy outcomes was higher than in the control group,with OR(95% Cl=1.473,1.124~1.930).4.Compared to pregnant women in the control group,women in the pure TPOAb Positive group during pregnancy had a highter incidence of premature rupture of membrane(21.59%),postpartum hemorrhage(8.45%),premature birth(2.35%),Low birth weight(5.40%),children younger than the age of birth(9.62%),the difference is statistically significant(P<0.05),and the incidence of simple TPOAb positive adverse pregnancy outcomes was significantly higher than that of pregnant women in the control group(P<0.05).After adjust ment for potential confounding factors such as age,educational backgroun,the logistic regression model was used to find that pregnant women in the pure TPOAb positive group increased the risk of premature rupture of membrane(OR=1.333,95%Cl : 1.038~1.712),premature birth(OR=2.735,95%Cl : 1.262~5.928).Conclusion: 1.Pregnancy times ? 2,pregnant women age> 30 years can increase the risk of SCH in pregnancy to varying degrees.2.The age of pregnant women> 30 years old and the number of gestation times ? 1 increase the risk of TPOAb-positive to varying degrees.3.Pregnant women with gestational Sh have a higher risk of gestational diabetes,anemia, low birth weight,and fetal distress,and pregnancy SCH can significantly increase the incidence of adverse pregnancy outcomes.4.Simply TPOAb positive can significantly increase the risk of premature break of fetal membranes and premature birth.