Murat SEVAL, Melahat ATASEVER, Seda ŞAHİN AKER, Feride SÖYLEMEZ, Tuncay YÜCE

İlk Trimester TSH Düzeyinin Obstetrik ve Perinatal Sonuçlara Etkisi

Amaç: Gebelerde ilk trimester TSH seviyelerinin fetal doğum ağırlıklarına etkisini araştırmakGereç ve Yöntemler: Çalışmamız retrospektif bir çalışma olup Ankara Üniversitesi Kadın hastalıkları ve doğum bölümüne Ocak 2014-Ocak 2015 yılları arasında başvuran gebeliğinin ilk trimesterinde, tekil gebeliği olan 397 hasta dahil edilmiştir. Tiroid hastalıkları nedeniyle tedavi alanlar, diabetes mellitusu olanlar, preeklampsi gelişenler, kalp hastalığı olanlar, sigara ve alkol kullananlar ,37 haftadan önce doğum yapanlar çalışma dışı bırakılmıştır. Hastalar TSH seviyelerine göre iki gruba ayrıldı. Birinci grupta TSH seviyesi 0,5-2,5 mU/L Grup 1:202 hasta ve ikinci grupta TSH seviyesi 2,5-5 mU/L Grup 2:195 hasta idi. Gruplar doğum haftası, doğum kilosu, gravida, parite, Apgar skorları ,50 gr oral glukoz tolerans testi OGTT sonuçları, doğum şekli , erken membran rüptürü, intrauterin gelişme geriliği IUGR ,gebeliğin indüklediği hipertansiyon PIH , plasenta dekolmanı, abortus, intrauterin ölüm açısından karşılaştırılmıştır. Hastalar bebek doğum ağırlıklarına göre 3 gruba ayrıldı. Bunlar 2500 gram altı, 2500-4000 gram arası, 4000 gram üzerine göre sınıflandırıldı ve TSH düzeylerine göre bebek doğum ağırlıkları karşılaştırıldı.Sonuç : Gruplar arasında sezeryan doğum açısından TSH =2,5-5,0 mU/l olan grupta Grup 2 daha yüksek oranda idi ve istatistiksel olarak anlamlı fark izlendi p=0,018 . Her iki grup arasında 5. dakika Apgar skorları grup 1’de istatistiksel olarak anlamlı yüksek idi p=0,002 . Her iki TSH grubunda da doğum ağırlıkları açısından sonuçlar benzerdi ve istatistiksel olarak anlamlı bir fark izlenmedi p=0,41 .Tartışma : Tiroid fonksiyon bozukluklarının gebeliğin seyrine olumsuz etkisi bilinmektedir. İlk trimester TSH düzeyinin fetal doğum ağırlığına etkisini ortaya koymak için daha geniş çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

İlk trimester TSH seviyeleri, tiroid disfonksiyonu, fetal doğum ağırlığı

The Association of First Trimester TSH Levels With Obstetric and Perinatal Outcomes

Aim: To investigate the association of first trimester TSH levels in pregnant woman with the fetal birth weights.Material and Methods : The study was a retrospective study at Ankara University Ostetrics and Gynecology in January 2014 to January 2015 . 397 singleton pregnancies, the first trimester were included in the study. Thyroid disease history, diabetes mellitus, preeclampsia, heart disease, cigarettes and alcohol use, birth before 37 weeks of gestation were excluded from study. Patients were divided into two groups according to TSH levels. TSH levels in the first group of 0.5-2.5 mU / L Group 1:202 patients and the second group TSH level 2.5-5 mU / L Group 2:195 patients , respectively. Groups were compared with gestational age, birth weight, gravity, parity, Apgar scores, 50 g oral glucose tolerance test OGTT results, method of delivery, premature rupture of membranes, intrauterine growth retardation IUGR , pregnancy -induced hypertension PIH , placental abruption, miscarriage, fetal death.Patients were divided into 3 groups according to birth weights 4000 g and compared birth weights according to TSH levels .Results : Cesarean delivery was observed at higher rates in group 2, respectively, and the difference was statistically significant p = 0.018 . 5th minute Apgar scores was statistically significantly higher in group 1 p=0,002 . Birth weight results were similar in groups and a statistically significant difference was not observed p = 0.41 Conclusion: Thyroid dysfunctions have a negative impact on the pregnancies and we need for further studies to determine the relationship with first trimester TSH levels and fetal birth weight

Keywords:

First trimester TSH levels, thyroid disfunction, fetal birth weight,

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