The Influence Of TPOAb And/or TgAb Positive On The Incidence Of Gestational Diabetes And Pregnancy Outcome

Objective: To study the influence of TPOAb and/or TgAb positive with normal thyroid function on the incidence of gestational diabetes and the maternal and infant outcomes.Methods: 452 pregnant women who were hospitalized and delivered in our obstetric ward were divided into group A(TPOAb-TgAb-),group B(TPOAb+),group C(TgAb+),and group D(TPOAb+TgAb+);Group A(TPOAb and TgAb levels are within the normal range,n=330),Group B(TPOAb levels are greater than 34U/ml,n=39),Group C(TgAb levels are greater than 115U/ml,n=46),Group D(TPOAb and TgAb levels are both higher than the normal range,n=37),General information,biochemistry,blood glucose,adverse pregnancy outcomes,and neonatal complications were compared among the groups.Results: 1)The positive rate of TPOAb in early pregnancy was 8.6%,the positive rate of TgAb was 8.2%,the positive rate of TPOAb and TgAb was 10.2%,the antibody positive rates in the third trimester of pregnancy were 4.4%,2.4%,and 2.0%,respectively;2)The TPOAb titers in group B and group D were higher in the early pregnancy than in the late pregnancy(P<0.05),The TgAb titers in group B and group C were higher in early pregnancy than in late pregnancy(P<0.05);3)The late TSH and1 h PG in Group A were lower than those in Group B and Group D(P<0.05),The late FT4 in group A was lower than that in group D(P<0.05),The 1h PG in Group B was higher than that in Group C(P<0.05);4)The incidence of GDM and premature rupture of membranes in group B was significantly higher than that in group A(P<0.05);5)The positive rate of TPOAb in GDM group was significantly higher than that in non GDM group(P<0.05);6)There was a positive correlation between TPOAb and 1h PG in early pregnancy(P<0.01),There was a negative correlation between FT4 and fasting blood glucose,1h PG,and 2h PG in early pregnancy(P<0.05);7)The risk factors for GDM were age and TPOAb positive;FT4 in early pregnancy and weight gain during pregnancy are protective factors for GDM;8)The incidence of SCH in Group B(17.9%)was significantly higher than that in Group A(4.2%)(P<0.05).The incidence of SCH in Group C and Group D were 13.0% and 13.5%,respectively,with no statistical difference compared to Group A.Conclusion: Positive TPOAb and/or TgAb in patients with normal thyroid function can increase the risk of adverse pregnancy outcomes,especially GDM,premature rupture of membranes,and SCH.In clinical work,it is necessary to properly detect thyroid function and antibodies to reduce the risk of adverse pregnancy outcomes.