妊娠期单纯低甲状腺激素血症对胎儿头围发育的影响分析

The impact analysis of isolated hypothyroidism during pregnancy on fetal head circumference development

摘要

目的 探讨分析妊娠期单纯低甲状腺激素血症对于胎儿头围(HC)的影响。方法 选取2020年1月至12月在郑州大学第三附属医院产检的153例单胎孕妇为研究对象,将孕期检查提示妊娠期低甲状腺激素血症但未进行干预者归为未干预组(n=58),口服左甲状腺素片进行干预者归为干预组(n=49),产检甲状腺功能正常者归为正常组(n=46).分析三组孕妇其胎儿头围发育情况。结果 三组游离甲状腺激素(FT₄)水平差异具有统计学意义,两两比较发现未干预组的FT₄水平低于干预组及正常组(H=104.973,P<0.05);三组促甲状腺激素(TSH)水平差异无统计学意义(P>0.05);三组胎儿孕晚期头围发育水平差异具有统计学意义,两两比较发现未干预组出现胎儿头围小于孕周的概率高于干预组及正常组(χ²=11.781,P<0.05);三组胎儿在孕37周时双顶径(BPD)、HC值差异具有统计学意义,两两比较发现未干预组BPD、HC值小于干预组及正常组(F值分别为6.832、7.532,P<0.05);三组腹围(AC)、股骨长(FL)值差异无统计学意义(P>0.05);三组胎儿出生时头围水平差异具有统计学意义,两两比较发现未干预组的胎儿出生头围小于干预组及正常组(F=3.332,P<0.05);三组胎儿出生身长、出生体质量及出生孕周差异无统计学意义(P>0.05)。结论 妊娠期低甲状腺激素血症对于胎儿头围发育有负面影响,建议对低甲状腺激素血症及时干预,改善不良预后.

Abstract

Objective To explore and analyze the impact of isolated hypothyroidism during pregnancy on fetal head circumference (HC). Methods A total of 153 singleton pregnant women who underwent prenatal care at the Third Affiliated Hospital of Zhengzhou University from January to December 2020 were selected as study subjects. Those with gestational hypothyroidism detected during pregnancy but without intervention were classified into the non-intervention group (n=58), those who received oral levothyroxine tablets were classified into the intervention group (n=49), and those with normal thyroid function were classified into the normal group (n=46). The fetal HC development among the three groups was analyzed. Results There was a statistically significant difference in free thyroxine (FT₄) levels among the three groups, and pairwise comparison showed that the FT₄ level in the non-intervention group was lower than that in the intervention group and the normal group (H=104.973, P<0.05). There was no statistically significant difference in thyroid stimulating hormone (TSH) levels among the three groups (P>0.05). The difference in fetal HC development in the third trimester among the three groups was statistically significant, and pairwise comparison showed that the probability of fetal HC being smaller than gestational age was higher in the non-intervention group compared to the intervention group and the normal group (χ²=11.781, P<0.05). The differences in biparietal diameter (BPD) and HC values at 37 weeks of gestation among the three groups were statistically significant, and pairwise comparison showed that the BPD and HC values in the non-intervention group were smaller than those in the intervention group and the normal group (F=6.832, 7.532, P<0.05). There was no statistically significant difference in abdominal circumference (AC) and femur length (FL) values among the three groups (P>0.05). The difference in HC at birth among the three groups was statistically significant, and pairwise comparison showed that the HC at birth in the non-intervention group was smaller than that in the intervention group and the normal group (F=3.332, P<0.05). There was no statistically significant difference in birth length, birth body mass, and gestational age at birth among the three groups (P>0.05). Conclusion Hypothyroidism during pregnancy has a negative effect on fetal HC development. Timely intervention for hypothyroidism is recommended to improve adverse prognosis.

关键词

妊娠期单纯低甲状腺激素血症 / 孕期甲状腺功能 / 胎儿头围 / 游离甲状腺激素

Key words

isolated hypothyroidism during pregnancy / thyroid function during pregnancy / fetal head circumference / free thyroxine

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基金资助

国家自然科学基金重大科研仪器研制项目(62027827)