| Objective:This study attempts to establish the gestational month-specific stage (the first trimester of pregnancy, the second trimester of pregnancy, the third trimester of pregnancy) reference intervals for FT3(Free triiodothyronine), FT4(Free thyroxine), TSH (Thyroid stimulating hormone) in women in the area of Shijiazhuang. With the change of progesterone and estrogen in the body, other hormones except sex hormones at the same time also can produce changes. The thyroid hormone attracted much attention due to its important role. Thyroid disease during pregnancy can be divided into the original thyroid disease combined with pregnancy and pregnancy with thyroid disease two kinds. Thyroid function hyperfunction and hypothyroidism are two kinds of disease impact on the fetus. The incidence is about 1%-2%, what does not include a higher incidence of subclinical hyperthyroidism and hypothyroidism. Untreated hyperthyroidism during pregnancy,may lead to stillbirth, intrauterine retardation fetus, hyperthyroidism, respiratory distress, etc. Hypothyroidism during pregnancy may result in fetal anomalies, low birth weight, premature birth, abortion, placental abruption. Even affect the development of the nervous system, causing mental retardation, short stature, etc. The purpose of the routine examination of the thyroid function during pregnancy is for early discovery, early diagnosis, early treatment. According to clinical and subclinical thyroid dysfunction, doctors can give timely correcting for those pregnant women. Because of the adverse consequences of gestational thyroid diseases on the maternal, fetal, and neonatal, we should pay full attention to the appropriate intervention. Gestational thyroid hormone level assessment requires specific reference range of thyroid hormones level during pregnancy, but there is no unified gestational thyroid hormone levels in our country at present. We need to create a specific regional gestational thyroid hormone reference. Establish the region, gestational age, methods, specific reference range of thyroid hormones in the role of thyroid function evaluation is especially important.Methods:This experiment used the United States national institute of clinical and biochemical (NACB) guidelines recommending TSH normal reference range of methods.The object of study is the pregnancy women, who take routine inspection duiring the pregnancy in our hospital from May 2013 to March 2014. Inclusion criteria:(1) No family history of thyroid disease, past medical history or other autoimmune diseases; (2) No affect thyroid function of drugs (except estrogen) history; (3) No goiter; (4) Thyroid peroxidase antibody (TPOAb) negative; (5) No hyperemesis gravidarum, trophoblastic cells disease and preeclampsia; (6) Single pregnancy; (7) Anti thyroglobulin antibody (TgAb), thyroid stimulating hormone receptor antibody (TRAb) negative. We selected 412 women in pregnancy after this guidelines. The age of control group subjects from our physical examination center for healthy non pregnant women are between 20 to 37 years old. The inclusion criteria:(1) No history of infertility; (2) Normal menstrual cycle; (3) No family history of thyroid disease, past medical history or other autoimmune diseases; (4) No history of the administration of drugs affect the thyroid function; (5) No goiter; (6) Thyroid peroxidase antibody (TPOAb) negative; (7) Anti thyroglobulin antibody (TgAb), thyroid stimulating hormone receptor antibody (TRAb) negative. We collected 123 women as control group after screening. According to the different period of pregnancy, the 412 pregnant women were grouped, and then had statistical analysis. Taking 2ml venous blood from everyone after the physical examination on the naxt day stored in the procoagulant and placed in a -70 ℃ fridge for centralized testing. Serum used to measure thyroid stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3). Detect serum FT3, FT4, TSH level, divided into early pregnancy, mid-pregnancy, late pregnancy three groups, each groups of 143, 138,131. As each index from 2.5 to 97.5 percentage. All the data packets input EXCEL using SPSS 19.0 version for statistical analysis. Firstly the general index of age, pregnant weeks normal distribution inspection, accord with normal distribution, with X±S to represent. FT3 and FT4 accord with normal distribution, with X±S to represent. Comparing the two single-factor analysis of variance (one-way ANOVA) to compare. TSH was non-normal distribution, using the median to represent. Choosing 95% confidence interval and the reference range, namely P2.5 is lower limit, P97.5 for ceiling, between the two groups of two compares the nonparametric test (rank and inspection). P< 0.05 was considered statistically significant.Results:The reference range of FT3 during pregnancy in the trimester, middle and late stage respectively are 3.46-5.77 pmol/L,3.02-5.57pmol/L, 2.87-5.32 pmol/L; The reference range of FT4 during pregnancy in the trimester, middle and late stage respectively are 11.97-18.21 pmol/L, 8.38-17.79 pmol/L,8.21-16.35 pmol/L; The reference range of TSH during pregnancy in the trimester, middle and late stage respectively are 0.27-3.66 mIU/L,0.55-3.93 mIU/L,0.82-4.07 mIU/L.Conclusions:Specificity thyroid function reference range for normal pregnant women, that is good for disease diagnosis and correct treatment of gestational thyroid dysfunction. |
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