■自身免疫性甲状腺疾病是影响育龄妇女的常见病,导致甲状腺功能障碍并影响妊娠结局。虽然甲状腺激素在妊娠结局中的关键作用已经确立,在甲状腺功能正常的孕妇中,抗甲状腺过氧化物酶抗体(TPOAb)阳性与不良妊娠结局之间的潜在关联尚不清楚.
■本研究旨在探讨甲状腺功能正常的孕妇TPOAb阳性与不良妊娠结局之间的关系。
■我们收集了2009年2月至2012年6月到我院就诊的孕妇的基线信息。取血样测定促甲状腺激素(TSH),游离甲状腺素(FT4),TPOAb,和抗甲状腺球蛋白抗体(TGAb)。比较甲状腺功能正常的参与者中TPOAb阳性和TPOAb阴性组的不良妊娠结局发生率。
■总共包括7,046名甲状腺功能正常的孕妇,包括6,700个阴性TPOAb和346个阳性TPOAb。TPOAb阳性组的年龄更高(26.0vs.27.0年,p=0.02)和更高的血清TSH水平(1.72vs.1.94mIU/L,p=0.029),而采血的孕周较低(31.9vs.26.5周,p=0.001)。单变量分析显示,与TPOAb阴性组相比,TPOAb阳性妇女的后代低出生体重(LBW)的发生率更高(3.5%vs.1.9%,p=0.035)。在调整了年龄等混杂因素后,采血的孕周,月经史,教育水平,妊娠期糖尿病,妊娠期高血压,TGAb,TSH,和FT4,TPOAb阳性成为LBW婴儿的独立危险因素(OR:2.317,95%CI:1.057-5.076,p=0.036),而其他不良妊娠结局与TPOAb阳性无显著相关性.
■我们的研究结果表明,甲状腺功能正常的TPOAb阳性孕妇更有可能分娩LBW婴儿。定期监测TPOAb阳性妊娠,并在妊娠的所有阶段及时进行干预至关重要。
Autoimmune thyroid disease is a prevalent condition affecting women of reproductive age, leading to thyroid dysfunction and impacting pregnancy outcomes. While the critical role of thyroid hormone in pregnancy outcomes is well-established, the potential association between positive anti-thyroid peroxidase antibodies (TPOAb) and adverse pregnancy outcomes in pregnant women with normal thyroid function remains unclear.
This study aims to investigate the relationship between maternal TPOAb positivity and adverse pregnancy outcomes with normal thyroid function.
We collected baseline information from pregnant women who visited our hospital between February 2009 and June 2012. Blood samples were taken to measure thyroid stimulating hormone (TSH), free thyroxine (FT4), TPOAb, and anti-thyroglobulin antibodies (TGAb). The incidence of adverse pregnancy outcomes was compared between TPOAb-positive and TPOAb-negative groups among participants with normal thyroid function.
A total of 7,046 pregnant women with normal thyroid function were included, comprising 6,700 with negative TPOAb and 346 with positive TPOAb. The TPOAb-positive group exhibited a higher age (26.0 vs. 27.0 years, p = 0.02) and greater serum TSH levels (1.72 vs. 1.94 mIU/L, p = 0.029), while the gestational week of blood collection was lower (31.9 vs. 26.5 weeks, p = 0.001). Univariate analysis revealed a higher incidence of low birth weight (LBW) in offspring of TPOAb-positive women compared to the TPOAb-negative group (3.5% vs. 1.9%, p = 0.035). After adjusting for confounding factors such as age, gestational week of blood collection, menstrual history, education level, gestational diabetes, gestational hypertension, TGAb, TSH, and FT4, TPOAb positivity emerged as an independent risk factor for LBW infants (OR: 2.317, 95% CI: 1.057-5.076, p = 0.036), while other adverse pregnancy outcomes did not show a significant correlation with TPOAb positivity.
Our findings suggest that TPOAb-positive pregnant women with normal thyroid function are more likely to deliver LBW infants. Regular monitoring of TPOAb-positive pregnancies and timely interventions throughout all stages of pregnancy are crucial.