Pregnancy outcomes in pregnant women with subclinical hypothyroidism

doi:10.3877/cma.j.issn.1673-5250.2024.02.003

Objective

To investigate the pregnancy outcomes in pregnant women with subclinical hypothyroidism.

Methods

A total of 97 pregnant women with subclinical hypothyroidism admitted to Beijing Shunyi District Hospital from January 2021 to December 2022 were selected in this study. They were divided into intervention group (n=62, treated with levothyroxine sodium) and control group (n=35, not taking levothyroxine sodium) based on whether they received intervention treatment during pregnancy. The levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4), total thyroxine (TT4), thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) before treatment, two and six weeks after treatment, and before delivery, as well as adverse pregnancy outcomes, were compared between two groups. The procedures followed in this study were in accordance with the ethical standards set by the Ethics Committee of the Beijing Shunyi District Hospital and were approved by the committee (Approval No. 2024-L-011). Informed consents were obtained from all participants.

Results

① There were no statistically significant differences in general clinical data such as age, body mass index (BMI), gestational age, ethnic composition, gravidity, and parity between two groups (P>0.05). ② Repeated measures analysis of variance of serum TSH, FT4, and TT4 levels before treatment, two weeks and six weeks after treatment, and before delivery between two groups showed that effect of different treatment measures and time factors was statistically significant (F_{treatment × time}=18.49, 15.88, 13.06; P_{treatment×time}all <0.001). ③ Analysis of variance of repeated measurement data of variance of TPOAb and TgAb levels before treatment, two weeks and six weeks after treatment, and before delivery between two groups showed that effect of different treatment measures and time factors was statistically significant (F_{treatment×time}=21.06, 19.48; P_{treatment×time} all <0.001). ④ Analysis of variance of repeated measurement data of TC, TG, LDL-C, and HDL-C levels before treatment, two weeks and six weeks after treatment, and before delivery between two groups showed that effect of different treatment measures and time factors was not statistically significant (F_{treatment×time}=0.51, 0.76, 0.62, 0.85; P_{treatment×time}=0.600, 0.244, 0.594, 0.153). ⑤ The incidence of threatened abortion and premature rupture of membranes (PROM)were lower in intervention group than those in control group, and there were statistically significant differences between two groups (P<0.05). ⑥ There were no statistically significant differences in incidence of intrauterine fetal growth restriction, abortion, and preterm birth between two groups (P>0.05).

Conclusions

Intervention with levothyroxine sodium in pregnant women with subclinical hypothyroidism can improve subclinical hypothyroidism state during pregnancy, reduce levels of autoimmune antibodies in thyroid tissue, and decrease incidence of threatened abortion and PROM.

Key words: Hypothyroidism, subclinical state, Thyrotropin, Levothyroxine sodium, Pregnancy outcome, Fetal growth retardation, Pregnant women

表1 2组妊娠合并亚临床甲状腺功能减退孕妇的一般临床资料比较

组别	例数	年龄(岁，±s)	BMI(kg/m²，±s)	民族[例数(%)]		孕龄[例数(%)]
组别	例数	年龄(岁，±s)	BMI(kg/m²，±s)	汉族	少数民族	6周	7周
干预组	62	29.2±2.5	23.5±0.7	56(90.3)	6(9.7)	37(59.7)	25(40.3)
对照组	35	28.9±2.6	23.3±0.9	29(82.9)	6(17.1)	19(54.3)	16(45.7)
统计量		t＝0.68	t＝1.35	χ²＝0.57		χ²＝0.27
P值		0.502	0.179	0.452		0.606
组别	例数	孕次[例数(%)]		产次[例数(%)]		受孕方式[例数(%)]
组别	例数	1次	≥2次	0次	≥1次	自然受孕	胚胎移植
干预组	62	39(62.9)	23(37.1)	17(27.4)	45(72.6)	61(98.4)	1(1.6)
对照组	35	20(57.1)	15(42.9)	8(22.9)	27(77.1)	32(91.4)	3(8.6)
统计量		χ²＝0.31		χ²＝0.24		χ²＝1.26
P值		0.577		0.622		0.261

表1 2组妊娠合并亚临床甲状腺功能减退孕妇的一般临床资料比较

组别	例数	年龄(岁，±s)	BMI(kg/m²，±s)	民族[例数(%)]		孕龄[例数(%)]
组别	例数	年龄(岁，±s)	BMI(kg/m²，±s)	汉族	少数民族	6周	7周
干预组	62	29.2±2.5	23.5±0.7	56(90.3)	6(9.7)	37(59.7)	25(40.3)
对照组	35	28.9±2.6	23.3±0.9	29(82.9)	6(17.1)	19(54.3)	16(45.7)
统计量		t＝0.68	t＝1.35	χ²＝0.57		χ²＝0.27
P值		0.502	0.179	0.452		0.606
组别	例数	孕次[例数(%)]		产次[例数(%)]		受孕方式[例数(%)]
组别	例数	1次	≥2次	0次	≥1次	自然受孕	胚胎移植
干预组	62	39(62.9)	23(37.1)	17(27.4)	45(72.6)	61(98.4)	1(1.6)
对照组	35	20(57.1)	15(42.9)	8(22.9)	27(77.1)	32(91.4)	3(8.6)
统计量		χ²＝0.31		χ²＝0.24		χ²＝1.26
P值		0.577		0.622		0.261

表2 2组妊娠合并亚临床甲状腺功能减退孕妇甲状腺功能比较(

±s)

组别	例数	TSH(mU/L)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	3.9±1.0	2.4±0.7	1.8±0.3	1.6±0.3
对照组	35	3.8±0.9	3.9±0.9	4.3±1.3	5.6±1.7
F_治疗值/P_治疗值		16.82/<0.001
F_时间值/P_时间值		19.12/<0.001
F_{治疗×时间}值/P_{治疗×时间}值		18.49/<0.001
组别	例数	FT4(pmol/L)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	16.2±3.5	15.8±3.4	15.4±3.1	14.2±3.0
对照组	35	16.0±3.1	15.2±3.2	13.3±3.7	11.1±2.9
F_治疗值/P_治疗值		17.33/<0.001
F_时间值/P_时间值		12.02/<0.001
F_{治疗×时间}值/P_{治疗×时间}值		15.88/<0.001
组别	例数	TT4(nmol/L)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	116.5±19.3	153.3±22.8	149.0±17.3	141.5±19.8
对照组	35	118.9±21.7	130.6±25.8	128.8±21.6	120.0±17.4
F_治疗值/P_治疗值		14.93/<0.001
F_时间值/P_时间值		11.66/<0.001
F_{治疗×时间}值/P_{治疗×时间}值		13.06/<0.001

表2 2组妊娠合并亚临床甲状腺功能减退孕妇甲状腺功能比较(

±s)

组别	例数	TSH(mU/L)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	3.9±1.0	2.4±0.7	1.8±0.3	1.6±0.3
对照组	35	3.8±0.9	3.9±0.9	4.3±1.3	5.6±1.7
F_治疗值/P_治疗值		16.82/<0.001
F_时间值/P_时间值		19.12/<0.001
F_{治疗×时间}值/P_{治疗×时间}值		18.49/<0.001
组别	例数	FT4(pmol/L)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	16.2±3.5	15.8±3.4	15.4±3.1	14.2±3.0
对照组	35	16.0±3.1	15.2±3.2	13.3±3.7	11.1±2.9
F_治疗值/P_治疗值		17.33/<0.001
F_时间值/P_时间值		12.02/<0.001
F_{治疗×时间}值/P_{治疗×时间}值		15.88/<0.001
组别	例数	TT4(nmol/L)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	116.5±19.3	153.3±22.8	149.0±17.3	141.5±19.8
对照组	35	118.9±21.7	130.6±25.8	128.8±21.6	120.0±17.4
F_治疗值/P_治疗值		14.93/<0.001
F_时间值/P_时间值		11.66/<0.001
F_{治疗×时间}值/P_{治疗×时间}值		13.06/<0.001

表3 2组妊娠合并亚临床甲状腺功能减退孕妇TPOAb、TgAb水平比较(

±s)

组别	例数	TPOAb(IU/mL)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	72.3±28.5	69.9±25.4	57.3±19.4	50.3±13.7
对照组	35	68.1±24.6	74.0±27.0	86.6±23.7	92.3±29.9
F_治疗值/P_治疗值		14.74/<0.001
F_时间值/P_时间值		11.52/<0.001
F_{治疗×时间}值/P_{治疗×时间}值		21.06/<0.001
组别	例数	TgAb(IU/mL)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	67.9±21.9	61.8±19.5	54.3±16.4	47.3±15.0
对照组	35	64.0±20.8	68.5±23.8	75.9±25.2	96.7±31.2
F_治疗值/P_治疗值		15.13/<0.001
F_时间值/P_时间值		17.26/<0.001
F_{治疗×时间}值/P_{治疗×时间}值		19.48/<0.001

表3 2组妊娠合并亚临床甲状腺功能减退孕妇TPOAb、TgAb水平比较(

±s)

组别	例数	TPOAb(IU/mL)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	72.3±28.5	69.9±25.4	57.3±19.4	50.3±13.7
对照组	35	68.1±24.6	74.0±27.0	86.6±23.7	92.3±29.9
F_治疗值/P_治疗值		14.74/<0.001
F_时间值/P_时间值		11.52/<0.001
F_{治疗×时间}值/P_{治疗×时间}值		21.06/<0.001
组别	例数	TgAb(IU/mL)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	67.9±21.9	61.8±19.5	54.3±16.4	47.3±15.0
对照组	35	64.0±20.8	68.5±23.8	75.9±25.2	96.7±31.2
F_治疗值/P_治疗值		15.13/<0.001
F_时间值/P_时间值		17.26/<0.001
F_{治疗×时间}值/P_{治疗×时间}值		19.48/<0.001

表4 2组妊娠合并亚临床甲状腺功能减退孕妇血脂水平比较(

±s)

组别	例数	TC(mmol/L)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	4.8±0.8	4.7±0.6	4.9±0.6	4.9±0.8
对照组	35	4.9±0.9	4.8±0.8	5.0±0.6	4.9±0.8
F_治疗值/P_治疗值		0.42/0.745
F_时间值/P_时间值		0.30/0.816
F_{治疗×时间}值/P_{治疗×时间}值		0.51/0.600
组别	例数	TG(mmol/L)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	1.4±0.4	1.4±0.4	1.4±0.4	1.5±0.3
对照组	35	1.4±0.4	1.3±0.4	1.5±0.4	1.5±0.4
F_治疗值/P_治疗值		0.39/0.805
F_时间值/P_时间值		0.81/0.162
F_{治疗×时间}值/P_{治疗×时间}值		0.76/0.244
组别	例数	TC(mmol/L)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	2.1±0.9	2.1±0.9	2.1±0.8	2.2±0.8
对照组	35	2.0±0.9	1.9±0.9	2.2±0.8	2.2±0.8
F_治疗值/P_治疗值		0.54/0.598
F_时间值/P_时间值		0.64/0.580
F_{治疗×时间}值/P_{治疗×时间}值		0.62/0.594
组别	例数	HDL-C(mmol/L)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	1.1±0.2	1.0±0.2	1.1±0.2	1.1±0.1
对照组	35	1.1±0.2	1.1±0.2	1.1±0.2	1.0±0.2
F_治疗值/P_治疗值		0.69/0.432
F_时间值/P_时间值		0.72/0.326
F_{治疗×时间}值/P_{治疗×时间}值		0.85/0.153

表4 2组妊娠合并亚临床甲状腺功能减退孕妇血脂水平比较(

±s)

组别	例数	TC(mmol/L)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	4.8±0.8	4.7±0.6	4.9±0.6	4.9±0.8
对照组	35	4.9±0.9	4.8±0.8	5.0±0.6	4.9±0.8
F_治疗值/P_治疗值		0.42/0.745
F_时间值/P_时间值		0.30/0.816
F_{治疗×时间}值/P_{治疗×时间}值		0.51/0.600
组别	例数	TG(mmol/L)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	1.4±0.4	1.4±0.4	1.4±0.4	1.5±0.3
对照组	35	1.4±0.4	1.3±0.4	1.5±0.4	1.5±0.4
F_治疗值/P_治疗值		0.39/0.805
F_时间值/P_时间值		0.81/0.162
F_{治疗×时间}值/P_{治疗×时间}值		0.76/0.244
组别	例数	TC(mmol/L)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	2.1±0.9	2.1±0.9	2.1±0.8	2.2±0.8
对照组	35	2.0±0.9	1.9±0.9	2.2±0.8	2.2±0.8
F_治疗值/P_治疗值		0.54/0.598
F_时间值/P_时间值		0.64/0.580
F_{治疗×时间}值/P_{治疗×时间}值		0.62/0.594
组别	例数	HDL-C(mmol/L)
组别	例数	治疗前	治疗后2周	治疗后6周	分娩前
干预组	62	1.1±0.2	1.0±0.2	1.1±0.2	1.1±0.1
对照组	35	1.1±0.2	1.1±0.2	1.1±0.2	1.0±0.2
F_治疗值/P_治疗值		0.69/0.432
F_时间值/P_时间值		0.72/0.326
F_{治疗×时间}值/P_{治疗×时间}值		0.85/0.153

表5 2组妊娠合并亚临床甲状腺功能减退孕妇不良妊娠结局发生率比较[例数(%)]

组别	例数	妊娠期高血压疾病	妊娠期糖尿病	羊水量异常	先兆流产	流产	PROM	胎盘早剥
干预组	62	1(1.6)	2(3.2)	4(6.4)	2(3.2)	0(0)	2(3.2)	0(0)
对照组	35	4(11.4)	3(8.6)	7(20.0)	12(34.3)	1(2.9)	8(22.9)	2(5.7)
χ²值		2.63	0.44	2.85	17.48	－	7.32	1.34
P值		0.105	0.506	0.092	<0.001	0.361	0.007	0.247

表5 2组妊娠合并亚临床甲状腺功能减退孕妇不良妊娠结局发生率比较[例数(%)]

组别	例数	妊娠期高血压疾病	妊娠期糖尿病	羊水量异常	先兆流产	流产	PROM	胎盘早剥
干预组	62	1(1.6)	2(3.2)	4(6.4)	2(3.2)	0(0)	2(3.2)	0(0)
对照组	35	4(11.4)	3(8.6)	7(20.0)	12(34.3)	1(2.9)	8(22.9)	2(5.7)
χ²值		2.63	0.44	2.85	17.48	－	7.32	1.34
P值		0.105	0.506	0.092	<0.001	0.361	0.007	0.247

表6 2组妊娠合并亚临床甲状腺功能减退孕妇所分娩新生儿不良分娩结局发生率比较[例数(%)]

组别	例数	宫内生长受限	窒息	早产
干预组	62	1(1.6)	0(0)	1(1.6)
对照组	35	3(8.6)	1(2.9)	4(11.4)
χ²值		1.26	－	2.63
P值		0.261	0.361	0.105

表6 2组妊娠合并亚临床甲状腺功能减退孕妇所分娩新生儿不良分娩结局发生率比较[例数(%)]

组别	例数	宫内生长受限	窒息	早产
干预组	62	1(1.6)	0(0)	1(1.6)
对照组	35	3(8.6)	1(2.9)	4(11.4)
χ²值		1.26	－	2.63
P值		0.261	0.361	0.105

[1]	Lee SY, Pearce EN. Testing, monitoring, and treatment of thyroid dysfunction in pregnancy [J]. J Clin Endocrinol Metab, 2021, 106(3): 883-892. DOI: 10.1210/clinem/dgaa945.
[2]	Yap YW, Onyekwelu E, Alam U. Thyroid disease in pregnancy [J]. Clin Med (Lond), 2023, 23(2): 125-128. DOI: 10.7861/clinmed.2023-0018.
[3]	樊祯翠，徐志红. 妊娠期甲状腺功能减退发生情况及影响因素[J].中国计划生育学杂志，2021，29(2)：388-391. DOI: 10.3969/j.issn.1004-8189.2021.02.044.
[4]	Toloza F, Derakhshan A, Männistö T, et al. Association between maternal thyroid function and risk of gestational hypertension and pre-eclampsia: a systematic review and individual-participant data meta-analysis [J]. Lancet Diabetes Endocrinol, 2022, 10(4): 243-252. DOI: 10.1016/S2213-8587(22)00007-9.
[5]	Mayhew CE, Simonson KR, Ellsworth-Bowers ER. Antepartum care for pregnant people with overt hypothyroidism, subclinical hypothyroidism, and positive thyroid autoantibodies [J]. J Midwifery Womens Health, 2022, 67(3): 295-304. DOI: 10.1111/jmwh.13306.
[6]	Pop VJ, Hulsbosch LP, Boekhorst M, et al. Hypothyroid symptoms throughout pregnancy are predominantly associated with thyroxine and not with thyrotropin concentrations [J]. Thyroid, 2022, 32(10): 1249-1258. DOI: 10.1089/thy.2022.0244.
[7]	Chen J, Zhu J, Huang X, et al. Subclinical hypothyroidism with negative for thyroid peroxidase antibodies in pregnancy: intellectual development of offspring [J]. Thyroid, 2022, 32(4): 449-458. DOI: 10.1089/thy.2021.0374.
[8]	白芳，徐澈. 亚临床甲状腺功能减退个体化诊治的研究进展[J].中国医师进修杂志，2019, 42(12): 1146-1149. DOI: 10.3760/cma.j.issn.1673-4904.2019.12.021.
[9]	《妊娠和产后甲状腺疾病诊治指南》(第2版)编撰委员会，中华医学会内分泌学分会，中华医学会围产医学分会. 妊娠和产后甲状腺疾病诊治指南(第2版) [J]. 中华内分泌代谢杂志，2019, 35(8) : 636-665. DOI: 10.3760/cma.j.issn.1000-6699.2019.08.003.
[10]	Wu M, Wang Y, Yan C, et al. Study on subclinical hypothyroidism in pregnancy: a bibliometric analysis via CiteSpace [J]. J Matern Fetal Neonatal Med, 2022, 35(3): 556-567. DOI: 10.1080/14767058.2020.1729731.
[11]	Lecorguillé M, Léger J, Forhan A, et al. Pregnancy outcomes in women with preexisting thyroid diseases: a French cohort study [J]. J Dev Orig Health Dis, 2021, 12(5): 704-713. DOI: 10.1017/S2040174420001051.
[12]	Solha S, Mattar R, Teixeira P, et al. Screening, diagnosis and management of hypothyroidism in pregnancy [J]. Rev Bras Ginecol Obstet, 2022, 44(10): 999-1010. DOI: 10.1055/s-0042-1758490.
[13]	阮郑，白奇峰，钟海燕. 彩色多普勒超声联合甲状腺自身抗体检测在甲状腺癌早期诊断中的应用价值[J].中国医师进修杂志，2023, 46(8): 731-735. DOI: 10.3760/cma.j.cn115455-20220825-00754.
[14]	陈絮，詹玉茹，王纯华. 孕妇ABO血型联合甲状腺功能检测对预测妊娠期糖尿病的临床价值[J/OL]. 中华妇幼临床医学杂志(电子版), 2023, 19(5): 604-610. DOI: 10.3877/cma.j.issn.1673-5250.2023.05.015.
[15]	陈爱兰，曾小变，罗婕妤. 先兆流产早期血清Hcy、TPOAb、TGAb水平的变化及其预后分析[J].海南医学，2021, 32(7): 864-867. DOI: 10.3969/j.issn.1003-6350.2021.07.012.
[16]	孙春萍，刘皆，张伟，等. 左甲状腺素钠早期治疗对妊娠合并亚临床甲状腺功能减退症妊娠结局和胎儿的影响[J].安徽医药，2022, 26(12): 2520-2524. DOI: 10.3969/j.issn.1009-6469.2022.12.041.
[17]	Zhang J, Chen H, Dou X, et al. Association between gestational blood lipids and TSH levels and pregnancy outcome of patients with subclinical hypothyroidism [J]. Pak J Med Sci, 2023, 39(3): 721-725. DOI: 10.12669/pjms.39.3.7150.
[18]	李晶晶，许雅娟，蔡琰钧，等. 妊娠期亚临床甲状腺功能减退与脂质代谢的相关性研究[J].中国实用妇科与产科杂志，2022，38(2)：211-215. DOI: 10.19538/j.fk2022020119.
[19]	吴雪辉，李薇，吴欣瑜，等. 妊娠期甲状腺功能减退症患者血糖血脂水平与病情严重程度及妊娠结局的关系[J].中国计划生育学杂志，2023, 31(1): 182-186. DOI: 10.3969/j.issn.1004-8189.2023.01.039.
[20]	杨威，高爽，张慧芳. 妊娠合并甲减行左甲状腺素钠早期干预的有效性分析[J]. 中华内分泌外科杂志，2022, 16(2): 207-210. DOI: 10.3760/cma.j.cn.115807-20220127-00026.
[21]	Dash SC, Sahoo N, Rout U, et al. Outcomes with levothyroxine treatment in early pregnancy with subclinical hypothyroidism [J]. Cureus, 2022, 14(5): e24984. DOI: 10.7759/cureus.24984.
[22]	Leng T, Li X, Zhang H. Levothyroxine treatment for subclinical hypothyroidism improves the rate of live births in pregnant women with recurrent pregnancy loss: a randomized clinical trial [J]. Gynecol Endocrinol, 2022, 38(6): 488-494. DOI: 10.1080/09513590.2022.2063831.

[1]	Fang Tan, Jiaojiao Yang, Sihan Fan, Cailing Ye, Xueqin Ji. Diagnostic value of prenatal echocardiography in fetal congenital vascular rings[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(01): 37-41.
[2]	Xuewei He, Meiyu Gu, Tingting Wu. Application of ultrasonic uterine artery and endometrial blood flow parameters in predicting pregnancy outcome in patients with unexplained recurrent spontaneous abortion[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(11): 1158-1163.
[3]	Xue Lin, Meng Chen, Meilin Yang, Xinghui Liu, Hongyu Zhou. Perinatal outcomes of pregnant women with myasthenia gravis and risk factors for disease exacerbation of myasthenia gravis[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(02): 125-132.
[4]	Yisi Chen, Min Liang, Hongyu Li, Xue Xia, Yanxi Liu, Chenqu Li, Dan Wang. Value of multidisciplinary team management in perinatal period for pregnant women with chronic kidney disease[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(02): 133-139.
[5]	Zhou Jiang, Li Tang, Liu Yang, Lin Zou. Analysis of influencing factors of diagnosis time in infants with congenital hypothyroidism[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(06): 649-656.
[6]	Xuanyao Liu, Xiaoxi Zhao. Predictive value of single and combined detection of common prenatal screening indexes for pregnant women on fetal chromosomal abnormalities[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(06): 657-664.
[7]	Haoyuan Yang, Jie Gong, Qingwei Zou, Hang Ruan. Current research status on adverse pregnancy outcomes of maternal and infant in pregnant women with asthma[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 522-529.
[8]	Tiantian Chen, Xiaodong Wang, Haiyan Yu. Pregnancy outcome of twin pregnancy with Gitelman syndrome: a case report and literature review[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 559-568.
[9]	Xiaoqing Ju, Yunjie Jin, Xiaoyan Wang. Influencing factors of uterine rupture during vaginal delivery in patients with scarred uterus after cesarean section[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 575-581.
[10]	Juan Gu, Qingqing Sun, Fangfang Hu, Yijuan Cao, Yujuan Qi. Clinical application of endometrial receptivity array to improve pregnancy outcomes in women with repeated embryo implantation failure[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 582-587.
[11]	Beibei Wang, Qixiu Dong, Hongyan Xi, Qingyun Yu, Lijun Zhang, Guang Shi. Analysis of influencing factors of medical abortion failure of pregnant women in early pregnancy and construction of related prediction model and its predictive value for medical abortion success[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 588-594.
[12]	Xu Chen, Yuru Zhan, Chunhua Wang. Clinical value of ABO blood group combined with thyroid function in prediction of gestational diabetes mellitus[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 604-610.
[13]	Mengling Zhou, Zhiwei Xue, Shu Zhou. Changes in size of uterine myoma during pregnancy and its association with adverse pregnancy outcomes[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 611-615.
[14]	Benquan Wang, Fan Cui, Jun Qiu, Benhong Xiang. The effect of different thyroid surgery methods on improving insulin resistance[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(02): 208-211.
[15]	Yuyan Zhang, Bin Hu, Weihong Zhang, Mei Xu, Hui Zhu, Xinyue Yang, Hailing Liu. Relationship between echocardiography parameters and liver function during the second trimester of pregnancy and their predictive value for adverse pregnancy outcomes[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 499-504.

Viewed

Full text

Abstract

Please choose a citation manager

Content to export