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目的 对比分析高水碘地区和碘缺乏地区孕妇的碘营养水平及其甲状腺功能状况,为孕妇科学补碘提供依据.方法 于2016年选取全市碘缺乏地区的6个区,采取分层随机抽样方法,每个区抽取孕早、孕中、孕晚期的孕妇各约30名,6个区共545名(孕早、中、晚期各187、179、179名)孕妇采集其随机尿样25 ml测定尿碘;选取其中158名孕妇(孕早、中、晚期各56、51、51名),采集静脉非抗凝血3 ml测定血清甲状腺激素和甲状腺自身抗体.随机选取1个高水碘地区的267名孕妇(孕早、中、晚期各86、79、102名),测其尿碘及血清甲状腺激素和相关抗体.结果 高水碘地区孕早、中、晚期尿碘中位数分别为240.40、154.50、177.30 μg/L,均处于碘营养适宜的状态,碘缺乏地区分别为132.40、125.50、114.30μg/L,均处于碘不足的状态.两地区孕妇尿碘水平分布的差别具有统计学意义(P＜0.05).高水碘地区孕妇血清激素的水平均低于碘缺乏地区,差别具有统计学意义(P＜0.05).高水碘地区孕妇低FT4血症、亚甲减、甲减、甲亢、亚甲亢检出率依次为0.4％,2.6％,1.1％,1.1％,0,TGAb和TPOAb阳性率分别为8.2％和8.2％,而碘缺乏地区依次为1.9％,15.8％,0,0.6％,0,12.0％,13.3％.结论 天津市碘缺乏地区孕妇相较于高水碘地区孕妇而言碘营养水平较低,亚甲减检出率较高,应着重加强缺碘地区孕妇尿碘和甲状腺功能的监测.“,”Objective To analyze the iodine nutritional status and thyroid function of pregnant women in high water iodine area and iodine deficiency area comparatively to provide the basis for the scientific iodine of pregnant women.Methods In six selected iodine deficiency areas,30 pregnant wemen with different pregnancy stages were selected in each area by stratified random sampling method respectively;A total of 545 pregnant wemen,including 187 in early pregnancy,179 in middle and 179 in late,were selected for determination of urine iodine in 25 ml random urine sample;A total of 158 pregnant wemen,including 56 in early pregnancy,51 in middle and 51 in late,were randomly selected from the total for determination of thyroid hormones and thyroid antibodies with 3 ml non-anticoagulant venous blood.In an area with high water iodine,267 pregnant wemen,including 86 in early pregnancy,79 in middle and 102 in late,were selected for determination of urine iodine,thyroid hormones and related antibodies.Results The medians of urinary iodine levels were 240.40,154.50 and 177.30 μg/L for wemen in early,middle and late pregnancy in high water iodine area respectively,and 132.40,125.50,114.30 μg/L for those in iodine deficiency areas respectively.There was a significant difference in the level of urinary iodine in pregnant women between the two regions (P＜0.05).The levels of various hormones of pregnant women in iodine deficiency areas were higher than those in high water iodine area,and the difference was statistically significant (P＜0.05).In high water iodine area,the prevalences of lower FT4,hypothyroidism,hypothyroidism,hyperthyroidism and hyperthyroidism of pregnant women were 0.4％,2.6％,1.1％,1.1％,0 respectively,the positive rate of TgAb and TPOAb were 8.2％ and 8.2％ respectively,whereas they were 1.9％,15.8％,0,0.6％,0,12.0％,13.3％ in iodine deficiency area respectively.Conclusion The iodine nutrition level of pregnant women in iodine deficiency area is lower compared with the high water iodine area.The prevalence of subclinical hypothyroidism is higher.The monitoring of urinary iodine and thyroid function of pregnant women should be strengthened in iodine deficiency area.