Analysis Of 27 Cases Of Pregnancy Complicated With Subclinical Hypothyroidism

Objective To investigate the significance of thyroid peroxidase antibodies in pregnant women with sub hypothyroidism,and hormone replacement therapy on pregnancy outcome in pregnant women with subclinical hypothyroidism,to regulate the diagnosis and treatment of hypothyroidism during pregnancy,reduce the outcome of adverse pregnancy.Methods Retrospectively analyze the clinical data of 27 pregnant women with subclinical hypothyroidism,who took antenatal care and finally terminate pregnancy from December2015 to December 2016 at the Second Affiliated Hospital of Dalian Medical University.Clinical data includes the patients' ages,gestational ages that subclinical hypothyroidism was first diagnosed,thyroid peroxidase antibody situations,their treatments and their pregnancy situations.The above data were classified and analyzed by SPSS statistical software.Use spearman correlation coefficient to respectively compare the relationship between ages and thyroid peroxidase antibody,the relationship between gestational ages that subclinical hypothyroidism was first diagnosed and thyroid peroxidase antibody.The chi-square test was used to compare the relationship between thyroid peroxidase antibody and the impact of pregnancy outcomes respectively in the thyroid peroxidase antibody positive and negative groups.P <0.05 was statistically significant.Results1.Among all the 27 patients with subclinical hypothyroidism,15 patients were TPOAb(+),of9 patients who were treated with L-thyroxine system and 5 cases untreated.12 patients were TPOAb(-),9 cases were treated with L-thyroxine,4 cases not.Spearman correlationcoefficient analysis shows that the correlation coefficient between ages and TPOAb is 0.408,P=0.035,and there is statistical significance.2.Among all the 27 cases of pregnancy with subclinical hypothyroidism,21 cases were diagnosed in the first trimester(pregnancy 1 to 13 weeks),2 cases in the second trimester(14to 27 weeks of pregnancy),4 cases in the third trimester(28 to 39 weeks of pregnancy).Spearman correlation coefficient analysis shows that the correlation coefficient is 0.186,P=0.352,and there is no statistical significance.3.There were 14 patients with thyroid peroxidase antibody positive,13 patients with thyroid peroxidase antibody negative.The incidence of adverse pregnancy outcomes was significantly lower in thyroid peroxidase positive patients treated with levothyroxine than in untreated patients(P <0.05),and the difference was significant.Of all the thyroid peroxidase negative patients,the adverse pregnancy outcome between patients treated by levothyroxine and patients who were untreated,was no significant difference(P> 0.05).Conclusion1.TPOAb was positively correlated with the age of patients and was statistically significant.The older the age was,the more likelihood of TPOAb appearing.There was no statistically significant association between the gestational age and TPOAb in the first group of patients with hypothyroidism.2.Patients treated with levothyroxine had a significantly lower rate of adverse pregnancy outcomes than untreated patients.In patients with thyroid peroxidase antibody-negative,there was no significant difference between the treatment and the untreated group.3.There are usually no obvious clinical symptoms in pregnancy patients who have subclinical hypothyroidism.In order to timely screening all pregnancy women of patients with thyroid dysfunction and thyroid autoantibody abnormalities,thyroid function test should be run as early as possible in prenatal care.And as soon as possible to get systemic levothyroxine treatment according to the guide of our country,thereby reducing adverse pregnancy outcomes.