妊娠期亚临床甲状腺功能减退对小于胎龄儿的影响因素分析OA

Objective To investigate the effect of subclinical hypothyroidism(SCH)on small for gestational age(SGA)infants through a retrospective study.Methods Pregnant women who delivered in Suzhou from 2019 to 2021 and their offspring were included.Maternal data from early pregnancy examinations and laboratory tests were extracted,and neonatal information such as birth weight and sex was obtained from birth records.According to thyroid function during pregnancy,participants were divided into a normal group and an SCH group.Binary logistic regression analysis was performed to examine the associations between various factors and SGA in the SCH group.Results A total of 86 089 eligible cases were included,with an SGA incidence of 4.91%.In both the normal group and the SCH group,early pregnancy body mass index(BMI)(OR=0.90,95%CI:0.89-0.92;OR=0.90,95%CI:0.86-0.94)and multiparity(OR=0.60,95%CI:0.54-0.67;OR=0.60,95%CI:0.41-0.88)were significantly associated with SGA(P<0.01).In the normal group,early pregnancy serum free thyroxine(FT4)(OR=1.02,95%CI:1.01-1.03),thyroid stimulating hormone(TSH)(OR=1.14,95%CI:1.10-1.20),and minority ethnicity(OR=1.32,95%CI:1.06-1.64)were identified as risk factors for SGA(P<0.05),whereas maternal reproductive history was a protective factor(OR=0.87,95%CI:0.78-0.96,P=0.005).However,these associations were not observed in the SCH group.Conclusion Multiparity,maternal reproductive history,and an appropriate body mass index in early pregnancy are protective factors against SGA.Therapeutic interventions in pregnant women with SCH appear to be effective.