育龄妇女孕前甲状腺功能异常现状及影响因素分析

doi:10.12183/j.scjpm.2022.0023

摘要/Abstract

摘要： 目的调查育龄妇女孕前甲状腺功能异常情况,并分析其相关影响因素。方法以2018年6月至2020年5月于郑州市某医院进行孕前优生健康检查的育龄妇女为研究对象进行问卷调查、体检资料收集及甲状腺功能检测,采用描述流行病学分析方法进行甲状腺功能异常情况分析,并采用单、多因素分析方法对甲状腺功能异常影响因素进行分析。结果本研究共对3 672名育龄妇女进行调查,年龄20~46岁,平均年龄（31.15±6.47）岁;BMI为17.30~30.23 kg/m²,平均为（23.58±4.03）kg/m²。检出341名甲状腺功能异常者,异常检出率9.29%。主要为亚临床甲状腺功能减退（54.84%）和亚临床甲状腺功能亢进（27.57%）。多因素分析结果表明年龄越大（OR=1.265）育龄妇女的甲状腺功能异常风险升高;与BMI 18.5~23.9 kg/m²组相比,BMI<18.5 kg/m²（OR=1.119）和≥24.0 kg/m²（OR=1.358）的育龄妇女甲状腺功能异常风险更高;与摄入碘盐组相比,食用非碘盐的育龄妇女甲状腺功能异常风险更高（OR=1.397）;有不良孕产史（OR=1.198）、吸烟（OR=1.520）、甲状腺疾病家族史（OR=3.025）、血压异常（OR=3.600）、血脂异常（OR=1.581）和血糖异常（OR=1.412）是育龄妇女甲状腺功能异常的危险因素。结论郑州市孕前优生健康检查的育龄妇女孕前甲状腺功能异常检出率较高,以亚临床甲状腺功能减退和亚临床甲状腺功能亢进较为常见,临床上孕前优生健康检查应重点关注高龄、体重异常、吸烟、碘摄入不足、有甲状腺疾病家族史,血压、血脂和血糖异常等育龄妇女的甲状腺功能,降低孕期相关疾病风险,为优生优育政策护航。

关键词: 育龄妇女, 孕前检查, 甲状腺功能, 异常, 影响因素

Abstract: Objective To investigate the thyroid dysfunction in women of childbearing age before pregnancy and analyze its related factors. Methods Questionnaire surveys, physical examination data collection, and thyroid function tests were carried out on women of childbearing age who underwent pre-pregnancy eugenic health examination in a hospital in Zhengzhou from June 2018 to May 2020. Descriptive epidemiological analysis method was used to analyze the thyroid dysfunction, and univariate and multivariate analysis methods were used to analyze its influencing factors. Results A total of 3 672 women of childbearing age were investigated, aged 20-46 years, with an average age of （31.15 ± 6.47） years. The body mass index （BMI） was 17.30-30.23 kg/m², with an average of （23.58 ± 4.03） kg/m². Among them, 341 cases of thyroid dysfunction were detected, and the detection rate was 9.29%, mainly subclinical hypothyroidism （54.84%） and subclinical hyperthyroidism （27.57%）. The results of multivariate analysis showed that the older （OR=1.265） women of childbearing age had an increased risk of thyroid dysfunction. Compared with the BMI 18.5-23.9 kg/m² group, women of childbearing age with BMI<18.5 kg/m² （OR=1.119） or ≥24.0 kg/m² （OR=1.358） had a higher risk of thyroid dysfunction. Compared with the iodized salt group, women of childbearing age who consume non-iodized salt had a higher risk of thyroid dysfunction （OR=1.397）. In addition, history of adverse pregnancy and childbirth （OR=1.198）, smoking （OR=1.520）, family history of thyroid disease （OR=3.025）, abnormal blood pressure （OR=3.600）, dyslipidemia （OR=1.581） and abnormal blood glucose （OR=1.412） were the risk factors of thyroid dysfunction in women of childbearing age. Conclusion The detection rate of thyroid dysfunction in women of childbearing age in Zhengzhou pre-pregnancy eugenic health examination is high, and subclinical hypothyroidism and subclinical hyperthyroidism are common. Clinically, the pre-pregnancy eugenics health examination should focus on women of childbearing age such as old age, abnormal weight, smoking, insufficient iodine intake, family history of thyroid disease, abnormal blood pressure, dyslipidemia and abnormal blood glucose, with a view to reducing the risk of pregnancy related diseases and escort the eugenics policy.

Key words: Woman of childbearing age, Pre-pregnancy examination, Thyroid function, Abnormal, Influencing factor

中图分类号:

R714.256

于柠, 赵会丹, 郭煜, 翟蕾. 育龄妇女孕前甲状腺功能异常现状及影响因素分析[J]. 华南预防医学, 2022, 48(1): 23-27.

YU Ning, ZHAO Hui-dan, GUO Yu, ZHAI Lei. Thyroid dysfunction in women of childbearing age before pregnancy and its influencing factors[J]. South China Journal of Preventive Medicine, 2022, 48(1): 23-27.

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