The Effects Of The Remedy For Subclinical Hypothyroidism During Pregnancy On The Mothers And Their Offspring

Objective: To explore the effects of levothyroxine on pregnancy complications,obstetric outcomes and offspring's neurologic development of pregnant women with subclinical hypothyroidism.Methods: There were 46 subjects in our study.Twenty-one subjects were assigned to case group using levothyroxine treatment,while 25 subjects were euthyroid and were included in control group.The case group according to their respective thyroid function was given appropriate L-T4,detected their thyroid function every 4 weeks,and got the target range as soon as possible.Collect basic demographics of all pregnant women and their offspring by means of questionnaires,follow-up maternal complications of pregnancy,obstetric outcomes.Follow up the information of offspring at 2-3 years old,including thyroid function and Gesell scale.Statistical analysis was carried out.Results:1.TSH level in the case group women was higher than in the control group(t=9.27,P=0.00).TPO-Ab was found positive in 6 subjects in case group(28.6%),0 subject in the control group,there was statistically significant difference between two groups(?2=5.89,P=0.02).2.Abnormal thyroid function of 2-3 years old offspring mainly expressed in elevated FT3 and TSH.Elevated FT3 were 25 cases,11 cases in case group and 14 cases in the control group,no statistical difference between groups(?2=0.06,P=0.81).5 subjects showed elevated TSH,among them,3 were in case group while 2 in the control group,no statistical difference between two groups(?2=0.04,P=0.84).One offspring in case group showed elevated FT3 and TSH.3.There were 3 cases with threatened abortion(14.3%),2 cases with anemia(9.5%)in the case group.There were no threatened abortion and anemia in the control group.The rate of threatened abortion and anemia in the case group and control group was not statistically significant difference(P>0.05).There were 14 cases of natural birth(66.7%)and 7 cases of cesarean(33.3%)in the case group.There were 15 cases of natural birth(60%)and 10 cases of cesarean(40%)in the control group,no statistically significant difference was found between two groups(?2=0.22,P=0.64).4.Abnormal neurologic development quotient of 2-3 years old offspring were 6 cases(28.6%)in the case group and 5 cases(20%)in the control group,no statistical difference between two groups(?2=0.46,P=0.50).The development quotient of adaptive development,large motor development,fine motor development,language development,and individual communication between two groups were no statistically significant difference(P>0.05).The development quotient below 85 percent of adaptive development,large motor development,fine motor development,language development,and individual communication between two groups were no statistically significant difference(P>0.05).Conclusion: 1.Early intervention for pregnant women with subclinical hypothyroidism was not only beneficial for the development of fetal thyroid,but also for the hypothalamus-pituitarythyroid axis to establish a normal feedback relationship.2.Early intervention for pregnant women with subclinical hypothyroidism can significantly reduce pregnancy complications.3.Early intervention for pregnant women with subclinical hypothyroidism can be conducive to the development of the nervous system of the fetus and the improvement of neurological function in the infant stage.4.Early screening for thyroid function in pregnant women and early intervention treatment were helpful for pregnant women and their offspring.