Abstract：【Objective】To investigate the relationship between hypothyroidism of pregnancy and spontaneous abortion in early pregnancy. 【Methods】 A total of 120 cases of hypothyroidism pregnant women in our hospital from March 2018 to March 2020 were selected as hypothyroidism group and 120 cases of subclinical hypothyroidism were selected as subclinical hypothyroidism group. In addition, 120 healthy pregnant women during the same time period were selected as the control group. The general data of all subjects were collected and compared, including age, body mass index (BMI), active and passive smoking, number of childbirth, and maternal status. The levels of serum thyroid stimulating hormone (TSH), free thyroid hormone (FT4) and the positive expression of thyroid peroxidase-Ab (TPO-Ab) were detected by immunofluorescence analysis. The pregnancy outcomes of the three groups were compared. The receiver operating characteristic curve (ROC) was drawn to analyze the diagnostic value of serum TSH and FT4 levels in spontaneous abortion in early pregnancy. Multivariate Logistic regression analysis was used to analyze the risk factors of spontaneous abortion in early pregnancy. 【Results】Compared with those in the control group, the serum TSH level and TPO-Ab positive rate in hypothyroidism group and subclinical hypothyroidism group were significantly higher (P<0.05), and the FT4 level was significantly lower (P<0.05). Further compared with those in subclinical hypothyroidism group, serum TSH level and TPO-Ab positive rate in hypothyroidism group were significantly higher (P<0.05) and FT4 level was significantly lower (P<0.05). In the order of control group, subclinical hypothyroidism group and hypothyroidism group, the proportions of pregnant women with spontaneous abortion, premature delivery, premature rupture of membranes, and postpartum anemia increased sequentially (P<0.05). The AUC of serum TSH and FT4 levels in hypothyroidism patients for diagnosing spontaneous abortion in early pregnancy was 0.786 and 0.779, respectively, and the AUC of combined detection of TSH and FT4 was 0.898. TPO-Ab positivity, abnormal increase of serum TSH level and abnormal decrease of FT4 level were risk factors of spontaneous abortion in early pregnancy (P<0.05). 【Conclusion】Hypothyroidism in pregnancy may increase the risk of spontaneous abortion in early pregnancy. The detection of thyroid function related indicators is helpful to evaluate spontaneous abortion in early pregnancy.
刘娟弟, 王瑞, 何菊仙. 甲状腺功能减退与孕早期自发性流产的相关性分析[J]. 医学临床研究, 2022, 39(2): 232-235.
LIU Juan-di, WANG Rui, HE Ju-xian. Relationship between Hypothyroidism and Spontaneous Abortion in Early Pregnancy. JOURNAL OF CLINICAL RESEARCH, 2022, 39(2): 232-235.
[1] ZHANG Y, ZHOU J, LI MQ, et al. MicroRNA-184 promotes apoptosis of trophoblast cells via targeting WIG1 and induces early spontaneous abortion[J].Cell Death Dis,2019, 10(3):223-226.
[2] MARTÍNEZ M, SOLDEVILA B, LUCAS A, et al. Hypothyroidism during pregnancy and its association to perinatal and obstetric morbidity: a review[J].Endocrinol Diabetes Nutr,2018, 65(2):107-113.
[3] ZHOU Y, WANG X, ZHANG Y, et al. Circulating MicroRNA profile as a potential predictive biomarker for early diagnosis of spontaneous abortion in patients with subclinical hypothyroidism[J].Front Endocrino,2018, 9(32):128-132.
[4] YANG Y, CHENG L, DENG X, et al. Expression of GRIM-19 in unexplained recurrent spontaneous abortion and possible pathogenesis[J].Mol Hum Reprod,2018, 24(7):366-374.
[5] 中华医学会内分泌学分会, 中华医学会围产医学分会. 妊娠和产后甲状腺疾病诊治指南[J].中华内分泌代谢杂志, 2012, 28(5):354-367.
[6] FREIS A, SCHLEGEL J, DANIEL V, et al. Cytokines in relation to hCG are significantly altered in asymptomatic women with miscarriage-a pilot study[J].Reprod Biol Endocrinol,2018, 16(1):93-98.
[7] 沈鉴东, 孙方西, 瞿殿云, 等. 妊娠早期自然流产组织染色体异常情况及其相关因素分析[J].中华妇产科杂志, 2019, 54(12):797-802.
[8] YAMAUCHI I, SAKANE Y, YAMASHITA T, et al. Effects of growth hormone on thyroid function are mediated by type 2 iodothyronine deiodinase in humans[J].Endocrine,2018, 59(2):353-363.
[9] 王凯亮, 朱海清, 韩旸, 等. 妊娠期妇女甲状腺功能减退对妊娠结局及子代智力的影响[J].中国医刊, 2020, 55(2):139-142.
[10] 李灵玲, 肖准. 妊娠合并甲状腺功能减退产妇分娩前后TSH浓度及分娩结局分析[J].现代中西医结合杂志, 2018, 27(23):2540-2547.
[11] 蒋宏, 况英. 甲状腺功能异常孕产妇发生稽留流产的临床分析[J].临床医学进展, 2019, 9(1):96-101.
[12] 徐晶, 柳林康, 谢小琴. 妊娠早期甲状腺功能减退症与妊娠结局及新生儿并发症的相关性[J].中国医学创新, 2018, 15(31):28-31.
[13] 陈红波, 亓立红, 谢少云. 孕早期促甲状腺素和β-人绒毛膜促性腺激素联合预测子痫前期的应用价值[J].中华生殖与避孕杂志, 2018, 12(11):893-897.
[14] 郝留凤. 妊娠中期亚临床甲状腺功能减低对母婴的影响[J].中国城乡企业卫生, 2018, 33(2):66-68.
[15] 向玲, 翟玲辉. 促甲状腺激素水平对妊娠期高血压综合征产妇妊娠结局的影响[J].湖南师范大学学报(医学版), 2018, 15(2):146-149.
[16] 柯贤钦. 胎膜早破合并胎盘早剥的影响因素及护理方式研究[J].养生保健指南, 2018, 85(11):225.
2022, Vol. 39 
