The Relationship Between Different TSH Levels And TPOAB Titers In Pregnant Women With Normal Thyroid Function At The End Of Pregnancy And Adverse Pregnancy Outcomes

Objective:The relationship between different TSH levels and TPOAb titers in pregnant women with normal thyroid function at the end of pregnancy and adverse pregnancy outcomes was analyzed through retrospective data.Methods:The complete clinical data of 632 pregnant women are retrospectively analyzed,whose gestational age of 28～41⁺⁶ weeks,delivery of live fetuses,and normal thyroid function in the end of pregnancy examination were carried out in maternity ward of the Second Hospital of Hebei Medical University from January 2020 to December 2020.1.According to the quarterback method,pregnant women were divided into 4 groups（N1～N4 group）according to the TSH level,N1 group（TSH0.550～1.431m IU/L）159 cases,N2 group（TSH 1.432～1.9875m IU/L）157cases,N3 group（TSH 1.9876～2.696m IU/L）158 cases,N4 group（TSH2.697～4.780m IU/L）158 cases.2.Taking the TSH level of 3.0m IU/L as the cut point,pregnant women were divided into 2 groups,group A（TSH 0.550～3.000m IU/L）512 cases,group B（TSH 3.001～4.780m IU/L）120 cases.3.According to the level of TPOAb,pregnant women were divided into TPOAb（+）group（>60IU/ml）106 cases and TPOAb（-）group（0～60IU/ml）526 cases.To compare the general conditions,the rate of adverse pregnancy outcomes such as hypertensive disorders complicating pregnancy,gestational transient thyrotoxicosis,anemia,premature rupture of membranes,preterm labor,postpartum hemorrhage,low birth weight,macrosomia,Apgar 1 minute score of 4～7 grading in the groups.Results:1.According to the quarterback method,the diastolic blood pressure of the N1 group was lower than that of the N4 group,and the gestational age of the N1 group was less than that of the N3 group.The difference had statistical significance（P<0.05）.The incidence of hypertensive disorders complicating pregnancy in the N3 and N4 groups was higher than that in the N1 group,and the incidence of preterm birth in the N3 and N4groups was lower than that of the N1 group.The difference had statistical significance（P<0.05）;2.Divided into 2 groups with a TSH value of 3.0m IU/L as the cut point,the diastolic blood pressure of group B was higher than that of group A.The difference had statistical significance（P<0.05）.The incidence of hypertensive disorders complicating pregnancy in group B was higher than that in group A.The difference had statistical significance（P<0.05）;3.Divided into TPOAb（+）group and TPOAb（-）group according to the level of TPOAb,there was no significant difference in adverse pregnancy outcomes between the two groups（P>0.05）.Conclusions:1.In pregnant women with normal thyroid function at the end of pregnancy,women in the higher thyroid stimulating hormone group have higher diastolic blood pressure and higher incidence of hypertension during pregnancy,while the incidence of preterm birth may be lower.2.Pregnant women with normal thyroid function at the end of pregnancy,regardless of the level of thyroid peroxidase antibody titers,have nothing to do with adverse pregnancy outcomes and fetal outcomes.