摘要目的: 分析妊娠期糖尿病合并甲状腺功能减退症危险因素及其对妊娠结局的影响。方法: 回顾性选取2019年1月到2021年12月收治的妊娠期糖尿病合并甲状腺功能减退症的114例产妇为观察组,选取同期收治的单纯妊娠期糖尿病产妇114例为对照组,探究影响因素,并分析对妊娠结局的影响。结果: 观察组与对照组的妊娠期高血压史、甲状腺疾病史、甲状腺疾病家族史、胎次、PT、TT、APTT、FDP、PTR、INR、ALT、UA比较差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,妊娠期高血压史、甲状腺疾病史、甲状腺疾病家族史、PT、TT为妊娠期糖尿病合并甲状腺功能减退症的独立影响因素(P<0.05);观察组产妇胎膜早破发生率(16.67% vs 6.14%)、早产发生率(12.28% vs 4.38%)以及新生儿低血糖发生率(6.14% vs 1.75%)和胎儿窘迫发生率(7.89% vs 1.75%)明显高于对照组(P<0.05)。结论: 妊娠糖尿病合并甲状腺功能减退症会增加不良妊娠结局的发生率,合并妊娠期高血压史、甲状腺疾病史、甲状腺疾病家族史及PT、TT异常是关键危险因素。
Abstract：Objective: To analyze the risk factors for gestational diabetes mellitus combined with hypothyroidism and its impact on maternal pregnancy outcome. Methods: A total of 114 parturients with gestatiional diabetes mellitus combined with hypothyroidism admitted from January 2019 to December 2021 were retropectively selected as the clinical observation group, and 114 parturients with gestational diabetes mellitus alone admitted during the same period were selected as the control group. The influencing factors were explored and the impact on pregnancy outcomes was analyzed. Results: Univariate analysis showed that gestational hypertension, previous history of thyroid disease, family history of thyroid disease, parity, PT,TT,APTT,FDP,PTR,INR,ALT and UA were risk factors for gestational diabetes combined with hypothyroidism (P＜0.05). Multivariate Logistic regression analysis showed that previous gestational hypertension, previous history of thyroid disease, combined family history of thyroid disease, PT, TT were independent influencing factors for gestational diabetes complicated with hypothyroidism (P＜0.050). The incidence of premature rupture of membranes (16.67% vs 6.14%), premature delivery (12.28% vs 4.38%), neonatal hypoglycemia (6.14% vs 1.75%) and fetal distress (7.89% vs 1.75%) in the observation group were significantly higher than those in the control group (P＜0.05). Conclusion: Pregnancy diabetes combined with hypothyroidism will increase the incidence of adverse pregnancy outcomes, and the history of pregnancy induced hypertension, thyroid disease, family history of thyroid disease and abnormal Pt and TT are the key risk factors.
李淑英, 葛晓春, 刘锐, 耿小婷, 郭艳巍. 妊娠期糖尿病合并甲状腺功能减退症的危险因素及对妊娠结局的影响[J]. 河北医学, 2022, 28(10): 1640-1643.
LI Shuying, GE Xiaochun, LIU Rui, et al. Risk Factors for Gestational Diabetes Mellitus Combined with Hypothyroidism and the Impact on Pregnancy Outcome. HeBei Med, 2022, 28(10): 1640-1643.
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2022, Vol. 28 
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