Efficacy of Levothyroxine Sodium Tablets in pregnant women with different thy-roid stimulating hormone levels and subclinical hypothyroidism during pregnancy
Objective To explore the therapeutic effect of Levothyroxine Sodium Tablets on the changes of folic acid(FA),homocys-teine(Hcy),thyroid peroxidase antibody(TPOAb)and pregnancy outcomes in pregnant women with different thyroid stimulating hormone(TSH)levels complicated with subclinical hypothyroidism(SCH)during pregnancy.Methods 152 patients with SCH du-ring pregnancy in the hospital were selected as the research subjects.According to the TSH level at initial diagnosis,the patients were divided into group Ⅰ(2.5 mIU·L-1＜TSH≤4.0 mIU·L-1,n=89)and group Ⅱ(TSH＞4.0 mIU·L-1,n=63).The both groups re-ceived Levothyroxine Sodium Tablets(Euthyrox)treatment.80 non-SCH pregnant women(TSH≤2.5 mIU·L-1)were enrolled as control group during the same period.The thyroid stimulating hormone(TSH)level during different pregnancy periods,serum bio-chemical factors[FA,Hcy,TPOAb,and 25-hydroxyvitamin D(25-OH-D)]before and after treatment and adverse pregnancy out-comes were tracked and followed up among the groups.Results There was no statistical difference in age,body mass index(BMI),gestational age and parity among the 3 groups,but there were statistically significant differences in the levels of serum free thyroxine(FT4)and free triiodothyronine(FT3)(P＜0.05).Before treatment,the level of serum TSH in group Ⅰ or group Ⅱ was signifi-cantly higher than that in control group(P＜0.05).The serum TSH levels at weeks 27 and 36 of pregnancy in groups Ⅰ and group Ⅱwere significantly decreased after treatment(P＜0.05),and were higher than those in control group(P＜0.05).The levels of serum FA and 25-OH-D in group Ⅰ before treatment were significantly higher than those in group Ⅱ(P＜0.05),while the levels of serum Hcy and TPOAb were significantly lower than those in group Ⅱ(P＜0.05).After treatment,the serum FA and 25-OH-D were signifi-cantly increased(P＜0.05),while the Hcy and TPOAb were significantly decreased(P＜0.05),but the differences in the above 4 levels were not statistically significant between the 2 groups.The adverse pregnancy rates of the 3 groups were 6.25％,10.11％and 15.87％respectively,without statistical difference.Multivariate Logistic regression analysis showed that the serum TSH,FT4 and TPOAb were the influencing factors of adverse pregnancy outcomes in patients with SCH during pregnancy(P＜0.05).Conclusion Levothyroxine Sodium Tablets has a significant efficacy in the treatment of pregnant women with different TSH levels and SCH during pregnancy,and it can effectively correct the disorders of serum biochemical factors and improve the pregnancy outcomes.The serum TSH,FT4 and TPOAb are the influencing factors of adverse pregnancy outcomes in patients with SCH during pregnancy.
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