Effect of L-thyroxine on pregnancy outcome,fetal and serum levels of hCG and SOD in pregnant women with hypothyroidism / 中国基层医药

ABSTRACT

Objective To investigate the effect of L-thyroid hormone on pregnancy outcome,fetal and serum human chorionic gonadotropin(hCG)and superoxide dismutase(SOD)in pregnant women with hypothyroidism.Methods From December 2015 to October 2016,86 pregnant women with hypothyroidism in the Women 's and Children's Hospital of Dongyang were divided into observation group(n=41)and control group(n=45)according to the treatment method.The control group was treated routinely.The observation group was treated with L-thyroxine sodium tablets on the basis of the control group.The levels of serum thyrotropin(TSH),thyroxine demand,serum hCG,SOD level,pregnancy outcome,neonatal growth,complications and clinical efficacy were observed and compared.Results The levels of TSH in pregnant women at the second trimester of pregnancy,the end of pregnancy and 1 week after birth were(1.85 ±0.64)mU/L,(1.32 ±0.36)mU/L,(0.41 ±0.33)mU/L,respectively,which was lower than that in the early pregnancy [(2.47 ±0.58)mU/L](t=3.210,8.154,14.479,all P<0.05).At the second trimester of pregnancy and late pregnancy,the thyroid hormone demand was(1.22 ±0.14)mg· kg-1 · d-1,(1.47 ±0.13)mg· kg-1· d-1,respectively,which was significantly higher than that of early pregnancy [(1.02 ± 0.22)mg· kg-1· d-1](t=3.339,8.531,all P<0.05).The thyroxine requirement at 1 week postpartum was(1.18 ± 0.15)mg· kg-1· d-1,which was lower than that at late pregnancy(t=9.202,P<0.05).There were no statistically significant differences in serum hCG and SOD between the two groups before treatment(all P>0.05).After treatment,the levels of serum hCG and SOD in the control group were(34587.81 ±8301.72)mU/L,(151.46 ±24.58)U/mL,respectively,which in the observation group were(43014.37 ±7879.43)mU/L,(174.53 ±31.66)U/mL,respectively,the differences were statistically significant(t=4.816,3.792,all P<0.05).The rate of spontaneous delivery in the observation group(80.49％)was higher than that in the control group(22.22％),and the incidence rates of cesarean section,early spontaneous abortion,preeclampsia and stillbirth were lower than those in the control group,the differences between the two groups were statistically significant(χ2 =29.132,4.051,4.398,5.386,4.836,all P<0.05).The scores of BSID,MDI and PDI of the observation group were(121.15 ±8.55)points,(120.89 ± 11.68)points and(118.57 ±6.52)points,respectively,which were higher than those of the control group [(103.76 ± 7.49)points,(106.15 ±9.73)points,(104.14 ±5.27)points](t=10.052,6.378,11.331,all P<0.05).The incidence rate of complication in the observation group was 4.88％,which was lower than 57.78％in the control group,the effective rate in the observation group was 95.12％,which was significantly higher than that 57.78％in the control group,the differences between the two groups were statistically significant(χ2 =27.341,16.210,all P <0.05).Conclusion L-thyroid hormone can effectively improve the serum hCG and SOD levels in pregnant women,improve the pregnancy outcome of pregnant women with hypothyroidism,reduce the incidence rate of complications and promote the healthy growth of newborns.