背景严重急性呼吸道综合征冠状病毒2(SARS-CoV-2)感染与孕产妇和胎儿发病率和死亡率增加有关。许多研究都证明了这一点。鉴于自身免疫性疾病在病毒感染期间的潜在恶化,产妇和胎儿并发症,如早产,低出生体重,或者先兆子痫,通常在妊娠合并甲状腺功能减退症的自身免疫性甲状腺炎中观察到,可能会进一步加重。这项研究旨在确定病毒感染和甲状腺功能减退之间的关联是否会导致不良妊娠结局的增加。方法本研究纳入145例感染SARS-CoV-2的孕妇队列,他在布加勒斯特大学急诊医院妇产科分娩,罗马尼亚,2020年1月1日至2022年12月31日。根据自身免疫性甲状腺炎伴甲状腺功能减退症的存在,将参与者分为两组。我们检查了母体和胎儿的人口统计学参数,临床旁实验室参数,和结果,旨在确定两组之间的差异。结果145例SARS-CoV-2阳性孕妇中,甲状腺功能减退症的患病率为8.96%,报告13例。在甲状腺功能减退组中,2019年冠状病毒病(COVID-19)患者的平均年龄更高(34.07±5.18岁与29.25±6.23年),调查的怀孕案件数量也是如此,12(92.31%)与91(68.94%)。出生时胎儿体重之间没有观察到统计学上的显着相关性,一分钟阿普加得分,新生儿重症监护病房(NICU)入院,或宫内生长受限。然而,在甲状腺功能减退症组中记录了一例死胎。甲状腺病理的存在并没有加剧病毒感染的进展,没有先兆子痫的病例证明,入住ICU,或SARS-CoV-2肺炎。相反,SARS-CoV-2感染的孕妇存在甲状腺功能减退症与较低的尿酸水平和国际标准化比值(INR)值略有下降相关.此外,甲状腺功能减退组的尿酸水平与1分钟Apgar评分呈显著负相关,而在另一组中没有观察到这种相关性。此外,宫内生长受限与尿酸值之间存在统计学上的显着相关性,以及一分钟阿普加评分和INR参数之间,在两组中。结论SARS-CoV-2感染与甲状腺功能减退症之间的联系似乎不会增加早产的风险,宫内生长受限,或出生时胎儿体重低。然而,它可能与更高的死产风险有关。COVID-19孕妇甲状腺功能减退症的存在与产妇尿酸水平较低和INR值略有下降相关。一分钟Apgar评分与SARS-CoV-2感染和甲状腺功能减退孕妇的尿酸水平相关。
Background Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection has been linked to increased maternal and fetal morbidity and mortality, as evidenced by numerous studies. Given the potential exacerbation of autoimmune diseases during viral infections, maternal and fetal complications such as preterm birth, low birth weight, or preeclampsia, often observed in pregnancies involving autoimmune thyroiditis with hypothyroidism, may be further aggravated. This study seeks to ascertain whether the association between viral infection and
hypothyroidism contributes to an increase in adverse pregnancy outcomes. Methods This study included a cohort of 145 pregnant women with SARS-CoV-2 infection, who delivered in the Department of Obstetrics and Gynecology of the University Emergency Hospital in Bucharest, Romania, between January 1, 2020, and December 31, 2022. The participants were divided into two groups depending on the presence of autoimmune thyroiditis with hypothyroidism. We examined the maternal and fetal demographic parameters, paraclinical laboratory parameters, and outcomes, aiming to identify disparities between the two groups. Results Among the 145 SARS-CoV-2-positive pregnant women, the prevalence of
hypothyroidism was 8.96%, with 13 cases reported. In the
hypothyroidism group, the mean age of coronavirus disease 2019 (COVID-19) patients was higher (34.07 ± 5.18 years vs. 29.25 ± 6.23 years), as was the number of cases of investigated pregnancies, 12 (92.31%) vs. 91 (68.94%). There was no statistically significant correlation observed between fetal weight at birth, one-minute Apgar score, neonatal intensive care unit (NICU) admission, or intrauterine growth restriction between the two groups. Nevertheless, a case of stillbirth was recorded in the
hypothyroidism group. The presence of thyroid pathology did not exacerbate the progression of the viral infection, as evidenced by the absence of cases of preeclampsia, ICU admission, or SARS-CoV-2 pneumonia. Conversely, the presence of
hypothyroidism in pregnant women with SARS-CoV-2 infection was associated with lower uric acid levels and a slight decrease in international normalised ratio (INR) values. Additionally, there was a significant negative association between uric acid levels and the one-minute Apgar score in the hypothyroidism group, while no such correlations were observed in the other group. Furthermore, there was a statistically significant correlation between intrauterine growth restriction and uric acid values, as well as between the one-minute Apgar score and INR parameters, in both groups. Conclusion The link between SARS-CoV-2 infection and hypothyroidism does not appear to increase the risk of preterm birth, intrauterine growth restriction, or low fetal weight at birth. However, it may be associated with a higher risk of stillbirth. The presence of hypothyroidism in pregnant women with COVID-19 correlates with lower maternal uric acid levels and a slight decrease in INR values. The one-minute Apgar score correlates with the level of uric acid in pregnant women with SARS-CoV-2 infection and hypothyroidism.