Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2019, Vol. 15 ›› Issue (01): 8 -13. doi: 10.3877/cma.j.issn.1673-5250.2019.01.002

Special Issue:

Original Article

Effects of iodine nutritional status on cardiac electrical signals of pregnant women in the second trimester pregnancy

Haihua Yu1, Jian Gong2,(), Guofeng Wang3, Song Yu4, Yanni Tang1   

  1. 1. Electrocardiogram Room in Department of Special Inspection, Haiyang People′s Hospital, Haiyang 265100, Shandong Province, China
    2. Department of Clinical Pharmacy, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning Province, China
    3. Department of Cardiology, Fourth Hospital of China Medical University, Shenyang 110032, Liaoning Province, China
    4. Department of Histology and Embryology, Liaoning University of Chinese Medicine, Shenyang 110847, Liaoning Province, China
  • Received:2018-07-30 Revised:2018-12-28 Published:2019-02-01
  • Corresponding author: Jian Gong
  • About author:
    Corresponding author: Gong Jian, Email:
  • Supported by:
    National Natural Science Foundation of China(81072182)
Objective

To investigate the effects of iodine nutritional status on cardiac electrical signals of pregnant women in the second trimester pregnancy.

Methods

From July 2015 to July 2017, a total of 1 600 pregnant women in the second trimester pregnancy were selected from two hospitals in Haiyang City, Shandong Province by convenience sampling method as the observation group, and 800 healthy non-pregnant women with normal iodine nutritional status were selected in the principle of age-matched as the control group (C group) during the same period in the same hospitals and by the same method. The iodine nutritional statuses of pregnant women in observation group were measured, and the electrocardiograms of all subjects were analyzed. According to the results of iodine nutritional status, the pregnant women in the second trimester pregnancy were divided into iodine deficiency subgroup (G1 subgroup), iodine excess subgroup (G2 subgroup), and iodine sufficiency subgroup (G3 subgroup), respectively. The rates of normal and almost normal electrocardiogram and the incidence of sinus arrhythmia and the other abnormal electrocardiogram results were compared by chi-square test. The study protocol was performed in accordance with the Helsinki Declaration of the World Medical Association revised in 2013, and clinical research informed consents were obtained from all participants.

Results

①There were 502 pregnant women in the second trimester pregnancy at the status of iodine deficiency, 179 cases of iodine excess, and 919 cases of iodine sufficiency. They were divided into G1, G2 and G3 subgroup, respectively. There were no statistical differences among 3 subgroups in age and gestational age (P>0.05). There was no statistical difference among 3 subgroups and C group in age (P>0.05). ②There was statistically significant difference in rate of normal and almost normal electrocardiogram among 3 subgroups in observation group and C group (χ2=79.889, P<0.001). The rate of normal and almost normal electrocardiogram was 72.71% (365/502), 70.95% (127/179) in G1 and G2 subgroup, respectively, which both were lower than those of 86.51% (795/919) and 88.25% (706/800) in G3 subgroup and C group, respectively, and all the differences were statistically significant (all P<0.001). ③The incidence of sinus arrhythmia was the highest among all abnormal electrocardiogram in observation group. There were statistically significant differences in incidence of sinus bradycardia (χ2=38.423, P<0.001), sinus tachycardia (χ2=37.687, P<0.001), sinus arrhythmia (χ2=296.887, P<0.001), premature ventricular contractions (χ2=20.933, P<0.001), short P-R interval (χ2=50.112, P<0.001), and ST-T changes (χ2=30.783, P<0.001) among 3 subgroups in observation group and C group. There were no statistically significant differences in the incidences of left or right deviation of electric axis, QRS low voltage, or conduction block among 3 subgroups in observation group and C group (P>0.05). ④There were statistically significant differences on the abnormal results of electrocardiogram examination in the pairwise comparison in sinus bradycardia (G1 subgroup vs C group: χ2=19.659, G2 subgroup vs C group: χ2=17.409, G1 subgroup vs G3 subgroup: χ2=20.592, G2 subgroup vs G3 subgroup: χ2=17.703, all P<0.001), sinus tachycardia (G1 subgroup vs C group: χ2=17.433, G2 subgroup vs C group: χ2=35.622, G2 subgroup vs G3 subgroup: χ2=16.992, all P<0.001), sinus arrhythmia (G1 subgroup vs C group: χ2=178.673, G2 subgroup vs C group: χ2=110.717, G1 subgroup vs G3 subgroup: χ2=168.011, G2 subgroup vs G3 subgroup: χ2=93.579, all P<0.001), ventricular premature beats (G1 subgroup vs C group: χ2=14.593, G1 subgroup vs G3 subgroup: χ2=13.472, all P<0.001), short P-R interval (G1 subgroup vs C group: χ2=43.563, G2 subgroup vs C group: χ2=19.291, G1 subgroup vs G3 subgroup: χ2=20.191, all P<0.001), and ST-T changes (G1 subgroup vs C group: χ2=19.796, G2 subgroup vs C group: χ2=23.314, G2 subgroup vs G3 subgroup: χ2=10.630, all P≤0.001) among G1, G2, G3 subgroup and C group.

Conclusion

Imbalance of iodine nutritional status of pregnant women in the second trimester pregnancy can lead to abnormal electrocardiogram.

表1 G1、G2及G3亚组中孕期孕妇与对照组受试者心电图检查结果的总体比较与两两比较[例数(%)]
组别 例数 正常和大致正常 异常
窦性心动过缓 窦性心动过速 窦性心律不齐 室性早搏
G1亚组 502 365(72.71) 41(8.17) 38(7.57) 155(30.88) 27(5.38)
G2亚组 179 127(70.95) 17(9.50) 23(12.85) 51(28.49) 9(5.03)
G3亚组 919 795(86.51) 26(2.83) 44(4.79) 51(5.55) 17(1.85)
C组 800 706(88.25) 22(2.75) 21(2.63) 33(4.13) 13(1.63)
总体比较 ? ? ? ? ? ?
? χ2 ? 79.889 38.423 37.687 296.887 20.933
? P ? <0.001 <0.001 <0.001 <0.001 <0.001
G1亚组vs G2亚组 ? ? ? ? ? ?
? χ2 ? 0.204 0.300 4.510 0.356 0.032
? P ? 0.652 0.584 0.034 0.551 0.858
G1亚组vs G3亚组 ? ? ? ? ? ?
? χ2 ? 41.223 20.592 4.621 168.011 13.472
? P ? <0.001 <0.001 0.032 <0.001 <0.001
G1亚组vs C组 ? ? ? ? ? ?
? χ2 ? 51.045 19.659 17.433 178.673 14.593
? P ? <0.001 <0.001 <0.001 <0.001 <0.001
G2亚组vs G3亚组 ? ? ? ? ? ?
? χ2 ? 26.940 17.703 16.992 93.579 5.243a
? P ? <0.001 <0.001 <0.001 <0.001 0.022
G2亚组vs C组 ? ? ? ? ? ?
? χ2 ? 34.501 17.409 35.622 110.717 6.239a
? P ? <0.001 <0.001 <0.001 <0.001 0.012
G3亚组vs C组 ? ? ? ? ? ?
? χ2 ? 1.173 0.010 5.499 1.867 0.126
? P ? 0.279 0.920 0.019 0.172 0.722
组别 例数 异常
短P-R间期 ST-T改变 电轴左偏或右偏 QRS低电压 传导阻滞
G1亚组 502 71(14.14) 30(5.98) 22(4.38) 23(4.58) 19(3.78)
G2亚组 179 22(12.29) 15(8.38) 9(5.03) 8(4.47) 10(5.59)
G3亚组 919 63(6.86) 29(3.16) 30(3.26) 27(2.94) 25(2.72)
C组 800 32(4.00) 12(1.50) 19(2.38) 17(2.13) 20(2.50)
总体比较 ? ? ? ? ? ?
? χ2 ? 50.112 30.783 5.611 7.340 5.902
? P ? <0.001 <0.001 0.131 0.068 0.119
G1亚组vs G2亚组 ? ? ? ? ? ?
? χ2 ? 0.384 1.235
? P ? 0.535 0.266
G1亚组vs G3亚组 ? ? ? ? ? ?
? χ2 ? 20.191 6.490
? P ? <0.001 0.011
G1亚组vs C组 ? ? ? ? ? ?
? χ2 ? 43.563 19.796
? P ? <0.001 <0.001
G2亚组vs G3亚组 ? ? ? ? ? ?
? χ2 ? 6.197 10.630
? P ? 0.013 0.001
G2亚组vs C组 ? ? ? ? ? ?
? χ2 ? 19.291 23.314a
? P ? <0.001 <0.001
G3亚组vs C组 ? ? ? ? ? ?
? χ2 ? 6.678 5.035
? P ? 0.010 0.025
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