A Preliminary Study On The Relationship Between Thyroid Dysfunction And Iodine Nutrition In Pregnant Women In Chengde Area Under The New Standard Condition And The Relationship Between Thyroid Dysfunction And Pregnancy Outcome

Objective:Based on the established reference range of pregnancy specific thyroid indexes in Chengde area,the correlation between iodine nutrition status and thyroid function and poor pregnancy outcome was studied.Methods:This study is divided into two parts,part 1:pregnant women who visited the outpatient department of Affilicated Hospital of Chengde Medical University between January 2017 to December 2017 were selected for urinary iodine,serum TSH,FT3 and FT4.Part 2: 2378 inpatients in the third trimester of pregnancy were selected during this period.The serum TSH,FT3,FT4,was measured and the pregnancy outcome was recorded.Finally,SPSS21.0 system was used to analyze the data.Age,gestational age,urinary iodine value and thyroid function indexes were described by median(lower quartile,upper quartile)[M(P25~P75)].The comparison between groups was performed by Kruskal-Wallis H test,Wilcoxon rank sum test was used for two independent samples.The counting data was expressed as the rate,and the comparison of the rate was tested witn Chi-aquare test,the difference was statistically significant when P<0.05,and the correlation was analyzed retrospectively.Results:(1)The median urinary iodine of pregnant women in Chengde area was 132.1?g/L,belonging to iodine deficiency state.(2)There was a significant difference in the incidence of thyroid disease between iodine appropriate group and iodine deficiency group,iodine beyond appropriate group and iodine excess group(P<0.05),among the thyroid disease in low T4 concentration was statistically significant(P < 0.05).(3)There was no significant difference in FT3 and TSH between the groups with different urinary iodine nutrition levels(P > 0.05);The levels of FT4 in iodine deficiency group and iodine deficiency group were significantly higher than those in iodine beyond appropriate group and iodine excess group,and the differences were statistically significant.(4)Thyroid dysfunction occurred in about 19% of the 2378 women in the third trimester,of which hypothyroxinemia was 15.89%,the most common.(5)The incidence of adverse pregnancy outcomes in hypothyroidism and subclinical hypothyroidism women was significantly higher than that in pregnant women with normal hypothyroidism.(6)There was a statistically significant difference in the incidence of adverse pregnancy outcomes between women with normal thyroid function and those with hypothyroxinemia.The incidence of hypertension in pregnant women with normal thyroid function was significantly lower than that in hypothyroxinemia group,and the treatment was statistically significant.And there was a significant difference in the incidence of adverse pregnancy outcomes between the treatment group and the untreated group.Conclusion:Most of women who are in the first trimester of pregnancy in Chengde area were in iodine deficiency level and should be supplemented with iodine,and the prevalence rate of thyroid disease in abnormal iodine group was significantly higher than that in iodine moderate group,so it was necessary to test the urinary iodine level for many times.Gestational thyroid disease is a common endocrine disease during pregnancy,which can lead to the occurrence of pregnancy hypertension,gestational diabetes mellitus and other adverse pregnancy outcomes.It is necessary to strengthen the monitoring of thyroid function in the third trimester of pregnancy.In addition,the detection of TPOAb in the third trimester of pregnancy is easy to ignore,worthy of attention.