Pregnancy outcomes in pregnant women with subclinical hypothyroidism
Objective To investigate the pregnancy outcomes in pregnant women with subclinical hypothyroidism.Methods A total of 97 pregnant women with subclinical hypothyroidism admitted to Beijing Shunyi District Hospital from January 2021 to December 2022 were selected in this study.They were divided into intervention group(n=62,treated with levothyroxine sodium)and control group(n=35,not taking levothyroxine sodium)based on whether they received intervention treatment during pregnancy.The levels of thyroid-stimulating hormone(TSH),free thyroxine(FT4),total thyroxine(TT4),thyroid peroxidase antibodies(TPOAb),thyroglobulin antibodies(TgAb),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C)before treatment,two and six weeks after treatment,and before delivery,as well as adverse pregnancy outcomes,were compared between two groups.The procedures followed in this study were in accordance with the ethical standards set by the Ethics Committee of the Beijing Shunyi District Hospital and were approved by the committee(Approval No.2024-L-011).Informed consents were obtained from all participants.Results ① There were no statistically significant differences in general clinical data such as age,body mass index(BMI),gestational age,ethnic composition,gravidity,and parity between two groups(P＞0.05).② Repeated measures analysis of variance of serum TSH,FT4,and TT4 levels before treatment,two weeks and six weeks after treatment,and before delivery between two groups showed that effect of different treatment measures and time factors was statistically significant(Ftreatment × time=18.49,15.88,13.06;Ptreatmentxtime all＜0.001).③ Analysis of variance of repeated measurement data of variance of TPOAb and TgAb levels before treatment,two weeks and six weeks after treatment,and before delivery between two groups showed that effect of different treatment measures and time factors was statistically significant(Ftreatment×time=21.06,19.48;Ptreatment×time all＜0.001).④ Analysis of variance of repeated measurement data of TC,TG,LDL-C,and HDL-C levels before treatment,two weeks and six weeks after treatment,and before delivery between two groups showed that effect of different treatment measures and time factors was not statistically significant(Ftreatment×time=0.51,0.76,0.62,0.85;Ptreatment×time=0.600,0.244,0.594,0.153).⑤ The incidence of threatened abortion and premature rupture of membranes(PROM)were lower in intervention group than those in control group,and there were statistically significant differences between two groups(P＜0.05).⑥ There were no statistically significant differences in incidence of intrauterine fetal growth restriction,abortion,and preterm birth between two groups(P＞0.05).Conclusions Intervention with levothyroxine sodium in pregnant women with subclinical hypothyroidism can improve subclinical hypothyroidism state during pregnancy,reduce levels of autoimmune antibodies in thyroid tissue,and decrease incidence of threatened abortion and PROM.
Hypothyroidism,subclinical stateThyrotropinLevothyroxine sodiumPregnancy outcomeFetal growth retardationPregnant women
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