Abstract: Objective　To analyze the effect of thyroid function during pregnancy on pregnancy outcomes. Methods　The data of the pregnant women in Puning Overseas Chinese Hospital from January 2018 to January 2020 were collected, and 3 752 pregnant women were selected for the experimental analysis according to the completion of the data. The incidences of thyroid dysfunction [clinical hypothyroidism, hyperthyroidism, and abnormal thyroid peroxidase antibody (TPOAb)], hypothyroidism (T4), thyroid nodules, thyrotoxicosis, and subclinical hypothyroidism (SCH) in the 3 752 women during pregnancy were analyzed. The 3 752 pregnant women were divided into a control group (2 980 cases with normal thyroid function), an SCH+TPOAb positive group (158 cases), an SCH+TPOAb negative group (265 cases), and a TPOAb positive group (349 cases). The pregnancy outcomes of the four groups were compared. χ² test was applied. Results　The incidences of complications in the SCH+TPOAb positive group, the SCH+TPOAb negative group,and the TPOAb positive group were 79.75% (126/158), 62.26% (165/265), 61.60% (215/349), respectively, compared with that in the control group [48.22% (1 437/2 980)],with  statistical differences (all P<0.05). There were statistical differences in spontaneous abortion, preterm birth, and full-term low birth weight infants between these four groups (χ²=24.456, 54.088, and 14.324; all P<0.05). Conclusion　Both positive or negative TPOAb in SCH and positive TPOAb alone can lead to pregnancy outcomes and multiple complications, such as pregnancy-induced hypertension, spontaneous abortion, gestational diabetes, term low birth weight infants, and preterm birth.

Key words: Second trimester, Abnormal thyroid function, Subclinical hypothyroidism, Pregnancy complications, Pregnancy outcomes

摘要：

目的　分析妊娠中期甲状腺功能对妊娠结果的影响。方法　收集普宁华侨医院在2018年1月至2020年1月期间妇产科收治的妊娠中期资料，根据资料完成程度选取3 752例孕妇进行试验分析，包括甲状腺功能异常［临床甲减、甲亢、单纯甲状腺过氧化物酶抗体（TPOAb）异常］、单纯低甲状腺素（T4）血症、甲状腺结节、甲状腺毒症、亚临床甲减（SCH）等的发生率。所有入选孕妇年龄20～35岁，孕周在（20.5±1.2）周。将3 752例妊娠中期妇女分为4组：对照组（2 980例，为甲状腺功能正常孕妇）、SCH+TPOAb阳性组（158例）、SCH+TPOAb阴性组（265例）、单纯TPOAb阳性组（349例），比较4组妊娠结局情况。统计学方法采用χ²检验。结果　SCH+TPOAb阳性组、SCH+TPOAb阴性组、单纯TPOAb阳性组的并发症发生率分别为79.75%（126/158）、62.26%（165/265）、61.60%（215/349），与对照组［48.22%（1 437/2 980）］比较，差异均有统计学意义（均P<0.05）。对照组、SCH+TPOAb阳性组、SCH+TPOAb阴性组、单纯TPOAb阳性组4组孕妇自发性流产、早产、足月低体重儿对比，差异均有统计学意义（χ²=24.456、54.088、14.324，均P<0.05）。结论　SCH伴TPOAb阳性或阴性、TPOAb单纯显示阳性全部可以出现妊娠结局以及出现多种并发症，例如妊娠期高血压、自发性流产、妊娠期糖尿病、足月低体重儿以及早产等。

关键词: 妊娠中期, 甲状腺功能异常, 亚临床甲减, 妊娠并发症, 妊娠结局