|
|
|
| Risk Factors for Gestational Diabetes Mellitus Combined with Hypothyroidism and the Impact on Pregnancy Outcome |
| LI Shuying, GE Xiaochun, LIU Rui, et al |
| The Affiliated Hospital of Chengde Medical University, Hebei Chengde 067000, China |
|
|
|
|
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.
|
|
|
|
|
|
[1] Jia,Minghan,Wu,Yanxin,Lin,et al.Meta-analysis of the association between maternal subclinical hypothyroidism and gestational diabetes mellitus[J].International journal of gynecology and obstetrics,2019,144(3):239-247.
[2] Zhang D,Cai K,Wang G,et al.Trimester-specific reference ranges for thyroid hormones in pregnant women[J].Medicine (Baltimore),2019,98(4):14245.
[3] 中华医学会妇产科学分会产科学组,中华医学会围产医学分会,中国妇幼保健协会妊娠合并糖尿病专业委员会.妊娠期高血糖诊治指南(2022)[第二部分][J].中华妇产科杂志,2022,57(2):81-90.
[4] Kemkem D,Nasteska A,Bray P,et al.Maternal hypothyroidism in mice influences glucose metabolism in adult offspring[J].Diabetologia,2020,63(9):1822-1835.
[5] 谢俊豪,李文文,金百翰,等.甲状腺素水平对妊娠糖尿病及妊娠结局的影响[J].解放军医学杂志,2020,45(4):423-429.
[6] 樊祯翠,徐志红.妊娠期甲状腺功能减退发生情况及影响因素[J].中国计划生育学杂志,2021,29(2):388-391.
[7] 黄晓燕,张高芝,臧循雄.妊娠期糖尿病孕妇血糖、糖化血红蛋白与甲状腺功能的相关性[J].中国妇幼保健,2018,33(4):760-763.
[8] Elbers LPB,Fliers E,Cannegieter SC.The influence of thyroid function on the coagulation system and its clinical consequences[J].Thromb Haemost,2018,16(4):634-645.
[9] 徐雅斐.妊娠糖尿病合并亚临床甲状腺功能减退对妊娠结局的影响[J].河南医学研究,2020,29(29):5446-5448. |
|
|
|
2022, Vol. 28 
