摘要
目的:探析高龄孕妇孕中期甲状腺激素、维生素B12水平与胎儿生长受限(FGR)的关联性并分析其对FGR的评估价值。方法:收集2021年7月-2024年7月本院收治的高龄(≥35岁)孕妇104例,观察孕中期孕妇促甲状腺激素(TSH)、游离四碘甲状腺原氨酸(FT4)、甲状腺过氧化物酶抗体(TPO-Ab)、维生素B12水平和FGR情况,分析甲状腺功能指标、维生素B12水平与FGR发生的关系。结果:FGR孕妇血清TSH、TPO-Ab水平高于非FGR孕妇,FT4、维生素B12水平低于非FGR孕妇(均P<0.05);Pearson相关性分析显示:血清TSH、TPO-Ab水平与胎儿腹围、头围、股骨长、双顶径呈负相关(P<0.05),FT4、维生素B12水平与胎儿腹围、头围、股骨长、双顶径成正相关(P<0.05)。logistic回归分析,孕妇年龄大、TSH高、TPO-Ab高是孕中期发生FGR的危险因素(P<0.05),体质指数高、FT4高、维生素B12水平高是孕中期发生FGR的保护因素(P<0.05);受试者工作特征曲线分析,TSH、FT4、维生素B12、TPO-Ab水平评估孕中期发生FGR的曲线下面积分别为0.763、0.705、0.782、0.772,敏感性均>90.0%。结论:FGR孕妇孕中期血清TSH、TPO-Ab、FT4等甲状腺功能指标水平异常变化及维生素B12水平偏低,这些指标异常是孕期发生FGR的相关因素,且对FGR有一定评估价值。
Objective:To explore the correlation between the levels of thyroid hormones and vitamin Bl2 of pregnant women with the advanced age and their fetal growth restriction(FGR)during the second trimester of pregnancy,and to analyze their values for evaluating the FGR of the women.Methods:A total of 104 pregnant women with the advanced age(≥35 years old)who admitted to the hospital from July 2021 to July 2024 were included to observe the levels of their thyroid stimulating hormone(TSH),free tetraiodothyronine(FT4),thyroid peroxidase antibody(TPOAb)and vitamin B12,and their FGR situation.The correlation between the thyroid function indexes levels and the vitamin B12 level of the women and their FGR occurrence was analyzed.Results:The levels of the serum TSH and TPO-Ab of the pregnant women with FGR were significantly higher than those of the pregnant women without FGR,and the levels of FT4 and vitamin B12 of the pregnant women with FGR were significantly lower(all P<0.05).Pearson correlation analysis showed that the serum TSH and TPO-Ab levels of the women were negatively correlated with their fetal circumference,head circumference,femoral length and biparietal diameter(P<0.05),and the FT4 and vitamin B12 levels of the women were positively correlated with their fetal abdominal circumference,head circumference,femoral length and biparietal diameter(P<0.05).Logistic regression analysis showed that the advanced age and the higher TSH and TPO-Ab levels of the women were the risk factors of their FGR occurrence during the second trimester of pregnancy(P<0.05),and the higher body mass index,and the higher levels of FT4 and vitamin B12 of the women were the protective factors of their FGR occurrence during the second trimester of pregnancy(P<0.05).Receiver operating characteristic curve analysis showed that the area under the curve of the TSH level,the FT4 level,the vitamin B12 level and the TPO-Ab level of the women for predicting their FGR occurrence during the second trimester of pregnancy were 0.763,0.705,0.782 and 0.772,respectively,and the sensitivities of which were all more than 90.0%.Conclusion:The changes of the abnormal levels of the serum thyroid function indexes,such as TSH,TPO-Ab,FT4 and other,and the vitamin B12 level of the pregnant women with FGR during the second trimester of pregnancy are lower,and which are the related factors those lead to the FGR of the women during pregnancy and have certain evaluated values for the FGR occurrence of the women.
作者
何露
吴金虹
杨堃
刘芳
HE Lu;WU Jinhong;YANG Kun;LIU Fang(Suining Central Hospital,Suining,Sichuan Province,629000)
出处
《中国计划生育学杂志》
2025年第6期1420-1424,1430,共6页
Chinese Journal of Family Planning
基金
四川省医学会(恒瑞)科研基金专项科研课题(2021HR54)。
关键词
高龄孕妇
胎儿生长受限
孕中期
甲状腺功能
维生素B12
评估
Pregnant women with advanced age
Fetal growth restriction
The second trimester of pregnancy
Thyroid function
Vitamin B12
Evaluation
