ObjectiveAdverse maternal outcomes and perinatal complications are closely associated with overt maternal hypothyroidism, but whether these complications occur in women with subclinical hypothyroidism (SCH) during pregnancy remains controversial. The aim of this study was to evaluate the effects of SCH on maternal and perinatal outcomes during pregnancy.MethodsA prospective study of data from 8012 pregnant women (371 women with SCH, 7641 euthyroid women) was performed. Maternal serum samples were collected in different trimesters to examine thyroid hormone concentrations. SCH was defined as a thyroid stimulating hormone concentration exceeding the trimester-specific reference value with a normal free thyroxine concentration. The occurrence of maternal outcomes, including gestational hypertension (GH), gestational diabetes mellitus, placenta previa, placental abruption, prelabor rupture of membranes (PROM), and premature delivery; and perinatal outcomes, including intrauterine growth restriction (IUGR), fetal distress, low birth weight (LBW; live birth weight ≤2500 g), stillbirth, and malformation, was recorded. Logistic regression with adjustment for confounding demographic and medical factors was used to determine the risks of adverse outcomes in patients with SCH.ResultsCompared with euthyroid status, SCH was associated with higher rates of GH (1.819% vs. 3.504%, P = 0.020; χ 2 = 7.345; odds ratio (OR), 2.243; 95% confidence interval (CI), 1.251–4.024), PROM (4.973% vs. 8.625%, P = 0.002; χ 2 = 72.102; adjusted OR, 6.014; 95% CI, 3.975–9.099), IUGR (1.008% vs. 2.965%, <0.001; χ 2 = 13.272; adjusted OR, 3.336; 95% CI, 1.745–6.377), and LBW (1.885% vs. 4.582%, P<0.001; χ 2 = 13.558; adjusted OR, 2.919; 95% CI, 1.650–5.163).ConclusionsThe results of this study indicate that pregnant women with SCH had increased risks of GH and PROM, and their fetuses and infants had increased risks of IUGR and LBW. Thus, routine maternal thyroid function testing is necessary to improve maternal and perinatal outcomes.
The prevalence of SCD is high in the ShunYi District in Beijing, China. Age, low education, less social support, and daily drinking are independent risk factors. The brief SCD-Q9 can be used as a reference.
Surgical treatment is effective for PCE. Accurate localization of epileptogenic zone and eloquent cortex are two key factors for favorable outcome. None of the diagnostic modalities shows obvious predictive value for favorable surgical outcome.
We investigated whether thyroid autoantibody status influences pregnancy outcomes in euthyroid women, by comparing abnormal pregnancy outcome rates between those who tested positive for thyroid autoantibodies (Ab+) and those who tested autoantibody-negative (Ab-). Euthyroid pregnant women (n=7,641) underwent tests for serum thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb). The subjects were divided into 4 groups according to thyroid antibody status: TPOAb-/TgAb- (92.9%); TPOAb+/TgAb- (3.2%); TPOAb-/TgAb+ (2.0%); and TPOAb+/TgAb+ (1.9%). The incidence rates of the following abnormal pregnancy outcomes were compared among the 4 groups and analyzed by Fisher's exact test: gestational diabetes, gestational hypertension, placenta previa, placental abruption, premature rupture of fetal membrane (PROM), intrauterine growth restriction, fetal distress, fetal anomalies, stillbirth, preterm birth, and low birth weight. Among the 4 groups, there were no significant differences in age, gestational age, or in the incidence rates of abnormal pregnancy outcomes, except for PROM and low birth weight. The highest incidence rates for PROM and low birth weight were in the TPOAb-/TgAb+ and TPOAb+/TgAb+ subjects, respectively. TgAb positivity and TPOAb positivity were associated with PROM and low birth weight, respectively. Underlying factors that govern the association between thyroid autoantibodies and PROM and low birth weight require further investigation.
To date, little epidemiological data are available on burns in China. This study describes the characteristics of burn patients admitted to a major burn center in Beijing to show trends in admission and outcomes in burned patients to share information about the current state of care for burned patients in our burn center. A retrospective study on 1974 burn patients admitted to Jishuitan Hospital in Beijing was conducted during the 9-year period from 2000 to 2008, and data were collected on age, gender, TBSA, etiology, length of hospital stay, mortality, and inhalation injury. The male:female ratio of the burn population was 2.41:1 and did not differ significantly over the study period (P > .05). The mean age of admission was 36 ± 16.3 years, and most patients were 30 to 39 years old (24.0%) or 20 to 29 years old (23.8%). The mean TBSA of burn was 14.7 ± 3.4%, ranging from 1 to 100%, and the mean size/age did not change significantly over the course of the study (P > .05). The incidence in burn injury decreased over the study period (P < .05). The most common cause of burn was flame (67.9%) followed by electrical (16.1%) and scald (9.5%). The mean length of hospital stay was 33.2 ± 3.5 days, extending from 1 to 413 days, and it did not differ significantly over the study period (P > .05). The mortality and inhalation injury rate were 2.8 and 6.9%, respectively. Annual mortality rate did not differ significantly over the study period (P > .05). This retrospective review of the specific epidemiological features of burn patients will provide important information for the development of proper control programs to reduce the incidence of burns and burn-related deaths.
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