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Study on the Effects of Different Doses of Levothyroxine Dodium Tablet Treatment on Thyroid Hormones,Pregnancy Outcome and Offspring Psychological Developmental Functions in Pregnant Women with Hypothyroidism During Pregnancy |
SHI Youwen, GAN Yu, XIE Qianqian, et al |
No.901 Hospital,Joint Logistics Support Force of the Chinese People's Liberation Army, Anhui Hefei 230031, China |
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Abstract Objective: To study the effects of different doses of levothyroxine sodium tablets on thyroid hormones,pregnancy outcomes and offspring psychological development of women with hypothyroidism during pregnancy. Methods: A total of 100 pregnant women with hypothyroidism treated with levothyroxine sodium tablets in the hospital from August 2020 to August 2021 were selected.They were divided into group A (25ug/time,54 cases),group B (50ug/time,25 cases) and group C (75ug/time,21 cases) according to the dose.Relevant parameters in the three groups were comparatively analyzed. Results: Thyroid function indicators in the three groups showed no statistically significant difference before treatment (P>0.05).After treatment,the levels of thyroid stimulating hormone (TSH) and thyroid peroxidase antibody (TPO-Ab) were significantly decreased,and the levels of free triiodothyronine (FT3) and free thyroxine (FT4) were significantly increased in all groups.The increases or decreases were significantly greater in group C than in group A and group B (P<0.05).The glucose and lipid metabolism in the three groups showed no statistically significant difference before treatment (P>0.05).After treatment,fasting plasma glucose (FPG),fasting insulin (FINS),total cholesterol (TC),low-density lipoprotein cholesterol (HDL-C),and triglyceride (TG) were decreased,while high-density lipoprotein Cholesterol (HDL-C) was increased in the three groups.The changes in group C were greater than those in group A and group B (P<0.05).There were significant differences in the incidence rates of gestational diabetes mellitus and premature rupture of membranes among the 3 groups (P<0.05).The incidence of gestational diabetes mellitus in group C was significantly lower than that in group A (P<0.05).The other pregnancy outcomes of the 3 groups showed no statistically significant difference (P>0.05).The scores of offspring's gross motor,adaptability and social behavior in group C were significantly higher than those in group A and group B (P<0.05),but there was no statistically significant difference in language and fine motor (P>0.05). Conclusion: Compared with low-dose levothyroxine sodium tablets,high-dose levothyroxine sodium tablets can better maintain normal thyroid function in pregnant women with hypothyroidism,regulate their glucose and lipid metabolism,lower the risk of adverse pregnancy outcomes,and improve offspring's neuropsychological development.
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[1] Martinez M,Soldevila B,Lucas A,et al.Hypothyroidism during pregnancy and its association to perinatal and obstetric morbidity:a review[J].Endocrinol Diabetes Nutr (Engl Ed),2018,65(2):107-113. [2] Hennessey JV,Espaillat R.Current evidence for the treatment of hypothyroidism with levothyroxine/levotriiodothyronine combination therapy versus levothyroxine monotherapy[J].Int Clin Pract,2018,72(2):e13062. [3] Mateo RCI,Hennessey JV.Thyroxine and treatment of hypothyroidism:seven decades of experience[J].Endocrine,2019,66(1):10-17. [4] 李进,张丽梅,于宁.妊娠期亚临床甲减对妊娠结局及围产儿的影响及甲状腺激素替代治疗效果观察[J].中国计划生育学杂志,2019,27(1):91-94. [5] 胡瑜.左旋甲状腺素片治疗亚临床甲状腺功能减退孕妇的剂量分析[J].山西医药杂志,2019,48(12):1480-1482. [6] 孙亚玲,辛春,郭明,等.左甲状腺素钠片治疗妊娠期合并甲状腺功能减退症的疗效观察[J].中国医院用药评价与分析,2020,20(7):788-791. [7] 谭艳丽,殷炽龙,陈云贞.左甲状腺素干预妊娠期亚临床甲状腺功能减退症对患者甲状腺功能及子代神经心理发育的短期影响[J].临床和实验医学杂志,2021,20(14):1504-1507. [8] Kampouri M,Margetaki K,Koutra K,et al.Maternal mild thyroid dysfunction and offspring cognitive and motor development from infancy to childhood:the Rhea mother-child cohort study in Crete,Greece[J].Epidemiol Community Health,2021,75(1):29-35. |
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