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Abstract To investigate the influence of subclinical hypothyroidism during pregnancy on pregnancy outcomes and perinatal infants, and to analyze the effect of thyroid hormone replacement therapy. Methods: The data of 302 pregnant women with subclinical hypothyroidism from February 2016 to June 2018 were collected retrospectively, and they were divided into thyroid hormone replacement (THR) group (232 cases) and untreated group (70 cases). In addition, data of other normal pregnant women during the same period were collected into control group (385 cases). The changes of levels of TSH, FT4 and FT3, the rate of adverse pregnancy, and outcomes of perinatal infants were compared among the three groups. Results: In the second trimester of pregnancy, the TSH level of women in THR group was the highest, and that in control group was lowest (P<0.05), and the TSH level of women during the third trimester of pregnancy in untreated group was significant higher than that of women in THR group or control group (P<0.05), but there was no significant different between THR group and control group (P>0.05). There were no significant different in levels of FT4 and FT3 of women during the second or third trimester of pregnancy among the three groups (P>0.05). There were no significant difference in the incidences of pregnancy hypertension, postpartum hemorrhage and placental abruption of women among the three groups (P>0.05). The incidences of gestational diabetes mellitus (GDM) and premature delivery of women in THR group were significant higher than those of women in the other two groups (P<0.05), and the incidence of GDM of women in THR group was significant higher than that of women in control group (P<0.05). There were no significant different in the rates of neonatal malformation, low birth weight, neonatal asphyxia, congenital hypothyroidism, and Apgar score of newborns among the three groups (P>0.05). Conclusion: Pregnant women with subclinical hypothyroidism can increase the adverse pregnancy outcomes risk, but had less adverse influence on perinatal infants. THR can effectively regulate the TSH level of pregnant women, can reduce the risks of GDM and premature delivery, and also can improve endocrine and better pregnancy outcomes of pregnant women with subclinical hypothyroidism.
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