Observation And Analysis Of Thyroid Function In Pregnant Women In Jingxiu District Of Baoding

Objective: To observe and analyze the characteristics of thyroid hormones levels,establish reference ranges of serum thyroid hormones of pregnant women in Jingxiu district,Baoding City,Hebei province.To analyze and compare the status of abnormal thyroid function in pregnancy.So as to provide suggestions for screening,dignosis,treatment thyroid disorders for pregnant women in our hospital and provide theoretical basis for the follow-up and intervention of women in pregnancy.Methods: The objects of our research were the 495 pregnant women(Research Group I),there were 163 women in the first trimester of pregnancy,177 women in second trimester of pregnancy and 155 women in third trimester of pregnancy,while 124 healthy women without pregnancy(control group)who took serum thyroid hormones and thyroid autoantibodies test in Jingxiu disitrct,Baoding City,Hebei province from Jan.2017 to Dec.2017.The pregnancy-specific reference ranges of serum TSH,FT4,FT3,TT4,TT3 levels of three stages of pregnancy were established based on 130 women in the first trimester of pregnancy,149 women in second trimester of pregnancy and 132 women in third trimester of pregnancy who conformed to the National Academy of Clinical Biochemistry(NACB)criteria.For pregnant women in Baoding Jingxiu district(Research Group I),according to the guidelines by ATA,to analyze the prevalence of thyroid disease for all pregnant women of the examination,and compare the differences of prevalence in TPOAb positive serum and negative serum group in Jingxiu disitrct.According to the pregnancy-specific reference ranges established in our study,we performed statistical analysis for thyroid diseases.To compare the difference between the reference ranges of establishing in this study and the diagnostic criteria established by ATAin 2011.Results:1.In our study,the pregnancy-specific reference ranges of serum TSH level for the three stages of pregnancy were 0.15-3.79mIU/L,0.22-4.03mIU/L,0.34-5.65mIU/L;the pregnancy-specific reference ranges of serum FT4 level for the three stages of pregnancy were 10.52-16.50pmol/L,8.21-14.45 pmol/L,7.69-13.65pmol/L;the pregnancy-specific reference ranges of serum FT3 level for the threestages of pregnancy were 3.64-6.01 pmol/L,3.02-5.45pmol/L,2.89-5.03 pmol/L;the pregnancy-specific reference ranges of serum TT3 level for the three stages of pregnancy were 2.14-4.32 nmol/L,2.22-4.36 nmol/L,2.15-4.10 nmol/L;the pregnancy-specific reference ranges of serum TT4 level for the three stages of pregnancy were 113.21-310.44 nmol/L,104.22-256.21 nmol/L,92.55-256.22nmol/L.2.The levels of FT3 and TSH of pregnant women in the time of pregnancy were lower than those in non-pregnant.The levels of TT3 and TT4 in each stage were higher than those in non-pregnant.During the whole gestation period,FT3,FT4,TT3 and TT4 tended to decrease with the increase of gestational weeks,while TSH gradually increased.3.The total positive rates of TPOAb and TGAb in pregnant women were 11.72% and 5.25%.The prevalence rates of hypothyroidism,subclinical hypothyroidism and hypothyroxinemia were 1.72%,13.79% and 8.62% in TPOAb positive pregnant women,and 0.23%,5.49% and 2.06% in TPOAb negative pregnant women.The TSH level of TPOAb positive pregnant women was higher than that of TPOAb negative(P<0.05).4.According to the standards recommended by the ATA guidelinds in 2011,the total prevalence rate of thyroid disorders in pregnant women was 12.53% in our hospital.The occurrence of clinical hypothyroidism,subclinical hypothyroidism,hypothyroxinemia,hyperthyroidism,and subclinical hyperthyroidism were 0.40%,6.46%,2.83%,0.81%,2.02%,and according to the pregnancy reference values obtained by this study,the total prevalence rate of thyroid disorders was 7.68%.The occurrence of clinical hypothyroidism,subclinical hypothyroidism,hypothyroxinemia,hyperthyroidism,and subclinical hyperthyroidism were 0.20%,2.02%,4.04%,0.20% and 1.21%.Conclusions:1.The reference ranges of thyroid parameters for pregnant women in Jingxiu district of Baoding was successfully established.2.Hypothyroidism in pregnancy was closely related to TPOAb.3.The incidence of subclinical hypothyroidism and hypothyroxinemia were high among all thyroid diseases during pregnancy.4.The standard of pregnancy reference values obtained by this study were used to screen the thyroid disease.The prevalence rate was lower than the prevalence rate of thyroid diseases according to the ATA guidelines of 2011.There was a great difference in the prevalence rate of the two.