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| Effect of levothyroxine for intervening pregnant women with subclinical hypothyroidism and negative TPOAB during different gestational weeks, and its influence on pregnancy outcomes and the neurological function of infants |
| The First Hospital of Yulin City, Shaanxi Province, 719000 |
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Abstract To investigate the influence of levothyroxine (LT4) for intervening pregnant women with subclinical hypothyroidism and negative thyroid gland peroxidase antibody (TPOAb) during different gestational weeks on the pregnancy outcomes and the neurological function of infants. Methods：1158 pregnant women with subclinical hypothyroidism and negative TPOAb were enrolled and divided into group A (447 women with 2.5 mIU/L<TSH level≤4.0 mIU/L) and group B (681 women with TSH level >4.0mIU/L) according to the different TSH levels from April 2015 to June 2019. Another 200 pregnant women with TPOAb negative and normal thyroid function were selected in group C. The women in group A were further divided into group A1 (257 women with LT4 treatment during less than 10 gestational weeks) and group A2 (220 women without LT4 treatment) according to LT4 treatment time. The women in group B were further divided into group B1 (198 women without LT4 treatment), group B2 (154 women with LT4 treatment during less than 10 gestational weeks), group B3 (176 women with LT4 treatment during 10-16 gestational weeks), and group B4 (153 women with LT4 treatment during 16-24 gestational weeks). The pregnancy outcomes, and the neurobehavioral and physical function of children with 1.5 years old assessed by Gesell Development Diagnosis Scales were analyzed. Results：The incidences of gestational diabetes mellitus and preterm delivery of the women in groups A2 and B1 were significant higher than those of the women in group C, group A1, group B4, group B3, and group B2 (P＜0.05). There were no significant differences in the values of physical development indexes (body weight, body length, and head circumference) of the children among these groups (P＞0.05). The neurobehavioral ability score of the children in group A2 was significant higher than that of the children in group B1, and which of the children in group B1 was significant lower than that of the children in group C (P＜0.05). There were significant differences in infant development quotient, response DQ, language DQ, and social abilities DQ among groups of the children among group B1, group B2, group B3, and group B4 (P＜0.05). The time of LT4 intervention for pregnant women was negatively correlated with the developmental quotient, the motor ability DQ, fine motor, the response, the social ability, and the language ability of their children (P＜0.05). Conclusion：The later intervention time of LT4 for pregnant women is, the higher incidence of gestational diabetes mellitus and premature delivery, and the more severity of neurobehavioral impairment of their infants.
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