بررسی فراوانی آنتی‌بادی تیروئید پراکسیداز مثبت و عوامل مرتبط با آن طی دوران بارداری در زنان باردار مراجعه کننده به مراکز تحت پوشش دانشگاه شهید بهشتی در سال ۹۵-۱۳۹۲

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار گروه مامایی، دانشکده پزشکی، دانشگاه آزاد اسلامی، واحد ورامین- پیشوا، تهران، ایران.

2 استاد گروه غدد درون‌ریز و متابولیسم، مرکز تحقیقات اندوکرینولوژی تولید مثل، پژوهشکده علوم غدد درون‌ریز و متابولیسم، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 استاد گروه مامایی و بهداشت باروری، مرکز تحقیقات مامایی و بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

4 دانشجوی دکترای آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی تهران، تهران، ایران.

5 استاد گروه غدد درون‌ریز و متابولیسم، مرکز تحقیقات غدد درون‌ریز، پژوهشکده علوم غدد درون‌ریز و متابولیسم، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: آنتی‌بادی تیروئید پراکسیداز (TPOAb)، عامل اصلی خطر اختلال عملکرد تیروئید در دوران بارداری است و می‌تواند نشانگر این اختلالات در دوران بارداری باشد. مطالعه حاضر با هدف ارزیابی فراوانی مثبت بودن TPOAb و عوامل مرتبط با آن در دوران بارداری انجام شد.
روش‌کار: این مطالعه یک تجزیه و تحلیل ثانویه است که بر اساس داده­های موجود در بررسی آینده‌نگر مبتنی بر جمعیت مطالعه تیروئید و بارداری تهران بر روی 2233 نفر از زنان باردار (سه ماهه اول بارداری) مراجعه‌کننده به درمانگاه­های مراقبت‌های دوران بارداری مراکز تحت پوشش دانشگاه شهید بهشتی انجام شد. اندازه‌گیری میزان سرمی TSH، T4، T-uptake و TPOab برای زنان باردار انجام شد. عوامل سن مادر، شاخص توده بدنی، تعداد حاملگی، سن حاملگی، سابقه فردی یا خانوادگی اختلالات تیروئید، گواتر، دیابت نوع یک یا سایر اختلالات خودایمنی، سابقه ناباروری، سابقه سقط جنین، زایمان زودرس یا مرده‌زایی به‌عنوان عوامل خطر احتمالی انتخاب شدند. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار STATA (نسخه 12) انجام گرفت.
یافته‌ها: در این بررسی 214 نفر (9/7%) TPOAb مثبت بودند. بر اساس مدل رگرسیون لوجستیک، شانس مثبت شدن TPOAb در افرادی که سابقه فردی بیماری تیروئید داشتند، 48/4 برابر (با فاصله اطمینان ۲۶/۲ و ۸۵/۸) بیشتر از افراد فاقد این سابقه بود (05/0p<). ارتباط معنی‌داری بین سایر عوامل مطرح شده (سن مادر، شاخص توده بدنی، تعداد حاملگی، سن حاملگی، مصرف داروی تیروئید، سابقه خانوادگی تیروئید، سابقه ناباروری، سقط و زایمان زودرس) با مثبت شدن TPOAb وجود نداشت (05/0p>).
نتیجه‌گیری: سابقه اختلالات تیروئید با مثبت بودن TPOAb در زنان باردار ارتباط داشته و این عامل می‌تواند به‌عنوان عامل خطری در شناسایی اختلالات اتوایمون تیروئید در نظر گرفته شود.

کلیدواژه‌ها

عنوان مقاله [English]

Frequency of positive thyroid peroxidase antibody and its related factors during pregnancy in pregnant women referring to the centers under coverage of Shahid Beheshti University of Medical Sciences, 2013-2016

نویسندگان [English]

  • Sima Nazarpour 1
  • Fahimeh Ramezani Tehrani 2
  • Masoumeh Simbar 3
  • Maryam Rahmati 4
  • Fereidoun Azizi 5
1 Assistant Professor, Department of Midwifery, Faculty of Medicine, Varamin-Pishva Branch, Islamic Azad University, Tehran, Iran.
2 Professor, Department of Endocrine and Metabolism, Reproductive Endocrinology Research Center، Research Institute for Endocrine Sciencesn, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Professor, Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 Ph.D. Student of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
5 Professor, Department of Endocrine and Metabolism, Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: Thyroid peroxidase antibody (TPOAb) is the main risk factor for thyroid dysfunction during pregnancy and can be a marker of these disorders during pregnancy. This study was performed with aim to evaluate the frequency of positive thyroid peroxidase antibody and its related factors during pregnancy.
Methods: This study is a secondary analysis which was performed based on the data available in prospective population based study of The Tehran Thyroid and Pregnancy Study. This study was performed on 2233 pregnant women (at first trimester of pregnancy) who referred to prenatal care centers under coverage of Shahid Beheshti University of Medical Sciences. Serum concentrations of T4، T-uptake، TSH and TPOAb were measured in pregnant women. Mother age، body mass index، parity، gestational age، individual or family history of thyroid dysfunctions، goiter، diabetes type 1 or other autoimmune disorders، history of infertility، abortion، preterm labor، or stillbirth were selected as probable risk factors. Data analysis was performed using STATA software (version 12).
Results: In this study، 214 cases (7.9%) were TPOAb positive. Based on the logistic regression model، the chance of positive TPOAb in women with individual history of thyroid disease was 4.48 times (95% CI: 2.26- 8.85) higher than those without this history (p <0.05). No significant relationship was found between other factors (maternal age, BMI, parity, gestational age, thyroid medication, family history of thyroid dysfunction, history of infertility, history of abortion and history of preterm labor) and positive TPOAb (P>0.05).
Conclusion: The history of thyroid disorders is associated with positive TPOAb in pregnant women and this factor can be considered as a risk factor for the detection of thyroid autoimmune disorders.

کلیدواژه‌ها [English]

  • pregnancy
  • Risk factors
  • Thyroid dysfunction
  • Thyroid Peroxidase Antibody

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مجله زنان، مامایی و نازایی ایران
دوره 21، شماره 7
مهر 1397
صفحه 20-28

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