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关婷, 张月, 张东梅, 杨娟, 胡序怀, 张宏光, 杨雪莹, 高华方, 赵君, 马旭. 初孕育龄女性孕前TSH水平异常与自然流产的关联[J]. 中国公共卫生, 2019, 35(12): 1652-1656. DOI: 10.11847/zgggws1124884
引用本文: 关婷, 张月, 张东梅, 杨娟, 胡序怀, 张宏光, 杨雪莹, 高华方, 赵君, 马旭. 初孕育龄女性孕前TSH水平异常与自然流产的关联[J]. 中国公共卫生, 2019, 35(12): 1652-1656. DOI: 10.11847/zgggws1124884
Ting GUAN, Yue ZHANG, Dong-mei ZHANG, . Association between pre-pregnancy thyroid stimulating hormone level and spontaneous abortion among first-time pregnant women[J]. Chinese Journal of Public Health, 2019, 35(12): 1652-1656. DOI: 10.11847/zgggws1124884
Citation: Ting GUAN, Yue ZHANG, Dong-mei ZHANG, . Association between pre-pregnancy thyroid stimulating hormone level and spontaneous abortion among first-time pregnant women[J]. Chinese Journal of Public Health, 2019, 35(12): 1652-1656. DOI: 10.11847/zgggws1124884

初孕育龄女性孕前TSH水平异常与自然流产的关联

Association between pre-pregnancy thyroid stimulating hormone level and spontaneous abortion among first-time pregnant women

  • 摘要:
      目的  分析初孕育龄女性孕前促甲状腺激素(thyroid stimulating hormone,TSH)水平与自然流产的关系,以提供两者关系的流行病学研究线索。
      方法  以2013年1月 — 2018年12月参加深圳市孕前优生健康检查且追踪到妊娠结局的18 797名初孕育龄女性为研究对象,将其中671例发生自然流产者作为病例组,18 126名正常活产者作为对照组,利用χ2检验比较2组间基线特征,采用多因素logistic回归模型分析初孕育龄女性孕前TSH水平对自然流产发生风险的影响。
      结果  育龄女性TSH水平降低率、正常高值率和升高率在正常活产组分别为2.27 %(412/18 126)、14.42 %(2 613/18 126)和4.14 %(751/18 126),在自然流产组分别为1.19 %(8/671)、14.16 %(95/671)和6.56 %(44/671),2组TSH水平构成有统计学差异。与孕前TSH水平正常组初孕育龄女性相比,TSH水平升高组发生自然流产的风险高出50 %(OR = 1.50,95 % CI = 1.05~2.08),TSH水平降低组和TSH水平正常高值组发生自然流产的风险无显著性差异。
      结论  初孕育龄女性孕前TSH水平升高可能增加自然流产的发生风险,针对孕前TSH水平升高的初孕育龄女性应加强孕前甲状腺功能指标监测。

     

    Abstract:
      Objective  To analyze the relationship between pre-pregnancy thyroid stimulating hormone (TSH) level and spontaneous abortion among first-time pregnant women and to provide clues for epidemiological research.
      Methods  From January 2013 to December 2018, we recruited 18 797 first-time pregnant women having pre-pregnancy eugenic health examination in Shenzhen city and with known pregnancy outcome and divided them into a case group (671 with spontaneous abortion) and a control group (18 126 with normal live birth). Chi-square test was used to compare baseline characteristics between the two groups and multivariate logistic regression model was adopted to analyze the impact of pre-pregnancy TSH level on spontaneous abortion risk in the women.
      Results  There was a significant difference between the cases and the controls in the distribution of pre-pregnancy TSH, with the decreased, normal high, and elevated rates of 2.27%, 14.42%, and 4.14% for the controls and 1.19%, 14.16%,and 6.56% for the cases, respectively. Compared to that for the women with normal pre-pregnancy TSH, the spontaneous abortion risk was 50% higher (odds ratio = 1.50, 95% confidence interval: 1.05 – 2.08) for the women with elevated pre-pregnancy TSH. No significant difference between the cases and the controls in the risk of spontaneous abortion among the women with normal high and decreased pre-pregnancy TSH levels.
      Conclusion  Elevated pre-pregnancy TSH level may increase spontaneous abortion risk among first-time pregnant women, suggesting that monitoring on thyroid function should be promoted among the first-time pregnant women with elevated pre-pregnancy TSH level.

     

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