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目的:探讨妊娠早期单纯甲状腺过氧化物酶抗体（thyroid peroxidase antibody，TPOAb）阳性和妊娠不良母婴结局的相关性。方法:回顾性分析2020年6月至2022年12月山西省儿童医院计划生育内分泌科接受早期产检的168例TPOAb阳性孕妇的临床资料，根据甲状腺功能情况分为A组（甲状腺功能正常合并TPOAb阳性，104例）和B组（甲状腺功能减退合并TPOAb阳性，64例）。另选择同期早期产检TPOAb阴性孕妇150例作为对照组。自首次产检开始随访至分娩后6周，记录3组孕妇和胎儿不良妊娠结局并采用 χ2检验进行组间比较。 结果:3组孕妇妊娠期糖尿病、胎膜早破和剖宫产等不良结局发生率比较差异有统计学意义（ P=0.028、0.003、0.006）。A组胎膜早破发生率显著高于对照组（ P=0.003）。B组孕妇妊娠期糖尿病、胎膜早破、剖宫产发生率均显著高于对照组（ P=0.008、0.003、0.001）。B组剖宫产发生率显著高于A组（ P=0.0461）。3组孕妇妊娠期高血压、子痫前期、羊水异常、胎盘早剥、流产、难产、死胎等不良结局发生率比较差异无统计学意义（ P=0.433、0.137、0.231、0.825、0.138、0.356、0.933）。3组胎儿早产、宫内窘迫、胎儿生长受限、病理性黄疸发生率比较，差异有统计学意义（ P=0.027、<0.001、0.008、0.038）。A组胎儿宫内窘迫、病理性黄疸发生率显著高于对照组（ P=<0.001、0.028），B组胎儿早产、宫内窘迫、胎儿生长受限、病理性黄疸发生率均显著高于对照组（ P=0.010、<0.000、0.001、0.014）。 结论:妊娠早期单纯TPOAb阳性可增加胎膜早破、早产、宫内窘迫、病理性黄疸等不良母婴结局发生率，早期筛查甲状腺功能和TPOAb并给予干预有助于减少不良母婴结局。

Objective:To explore the relationship between the positive thyroid peroxidase antibody (TPOAb) in early pregnancy and the adverse maternal and infant outcomes.Methods:A retrospective analysis was conducted on the clinical data of 168 TPOAb positive pregnant women who underwent early prenatal testing in Family Planning Endocrinology Department of Shanxi Children’s Hospital from Jun. 2020 to Dec. 2022. They were divided into group A (104 cases with normal thyroid function and TPOAb positive) and group B (64 cases with hypothyroidism and TPOAb positive) based on their thyroid function. Another 150 pregnant women with negative TPOAb during early prenatal testing during the same period were selected as the control group. Follow up was from the first prenatal examination to 6 weeks after delivery, the adverse pregnancy outcomes of three groups of pregnant women and fetuses were recorded, and chi square test for inter group comparison was used.Results:There were statistically significant differences in the incidence of adverse outcomes such as diabetes, premature rupture of membranes and cesarean section among the three groups ( P values were 0.028, 0.003 and 0.006, respectively). The incidence of premature rupture of membranes in group A was significantly higher than that in the control group ( P=0.003). The incidences of pregnancy diabetes, premature rupture of membranes and cesarean section in group B were significantly higher than those of the control group ( P=0.008, 0.003, 0.001, respectively). The incidence of cesarean section in group B was significantly higher than group A ( P=0.0461). There was no statistically significant difference in the incidence of adverse outcomes such as gestational hypertension, preeclampsia, abnormal amniotic fluid, placental abruption, miscarriage, difficult labor, and stillbirth among the three groups of pregnant women ( P values of 0.433, 0.137, 0.231, 0.825, 0.138, 0.356, and 0.933, respectively). The incidence rates of premature birth, intrauterine distress, fetal growth restriction, and pathological jaundice were compared among the three groups of fetuses, and the differences were statistically significant ( P<0.001, 0.008, 0.038, respectively). The incidence of intrauterine distress and pathological jaundice in group A was significantly higher than control group ( P<0.001, 0.028, respectively), while the incidence of premature birth, intrauterine distress, fetal growth restriction, and pathological jaundice in group B was significantly higher than the control group ( P<0.010, <0.000, 0.001, 0.014, respectively) . Conclusions:TPOAb positive in early pregnancy can increase the incidence of adverse maternal and infant outcomes such as premature rupture of membranes, preterm delivery, intrauterine distress, pathological jaundice, etc. Early screening of thyroid function and TPOAb and intervention will help reduce adverse maternal and infant outcomes.