母亲年龄与先天性甲状腺功能减低症的关联分析  

Analysis of association between maternal age and congenital hypothyroidism

作　　者：王丽雯[1] 赵德华[1] 张小安[1] 何婧文 罗春伟[1] WANG Li-wen;ZHAO De-hua;ZHANG Xiao-an;HE Jing-wen;LUO Chun-wei(Neonatal Disease Screening Center,The Third Affiliate Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]郑州大学第三附属医院新生儿疾病筛查中心,河南郑州450052

出　　处：《现代预防医学》2021年第2期373-377,共5页Modern Preventive Medicine

基　　金：郑州市协同创新重大专项(18XTZX12009)。

摘　　要：目的研究母亲年龄与先天性甲状腺功能减低症(CH)之间的关联。方法采用病例-对照研究设计,以2016年1月1日—2017年12月31日由河南省新生儿疾病筛查中心确诊的CH患儿作为病例组,按照1∶1比例匹配同性别、出生日期不超过30 d的健康新生儿作为对照组。采用条件logistic回归及限制性立方样条分析CH的风险因素。结果CH和对照人群共843对;经条件logistic回归分析,母亲生育年龄高[以21~<26岁组为参照,26~<31岁组、31~<35岁组、≥35岁组的OR调整(95%CI)分别为2.724(1.868~3.928)、6.845(4.136~11.372)、7.713(4.168~14.274)]、居住在农村[OR调整(95%CI)=1.577(1.090~2.281)]、有甲状腺疾病家族史[OR调整(95%CI)=9.574(3.462~26.750)]、有甲醛接触史[OR调整(95%CI)=7.322(2.967~18.066)]、有射线接触史[OR调整(95%CI)=7.663(2.521~23.293)]、有孕期用药史(抗生素、解热镇痛、非甾体)[OR调整(95%CI)=8.837(4.325~18.203)]、母亲学历低[OR调整(95%CI)=3.658(2.464~5.431)]、母亲孕期使用孕酮类保胎药[OR调整(95%CI)=0.159(0.076~0.333)]与CH存在一定关联,均P<0.05。随着母亲年龄的增加,新生儿发生CH的风险也在增加。结论母亲甲醛接触史、射线接触史、用药史、有甲状腺疾病家族史、居住在农村、学历低、生育年龄高是CH发生的危险因素。Objective To investigate the association between maternal age and congenital hypothyroidism(CH). Methods A case-control study was conducted. Children diagnosed with CH during January 1 st, 2016 and December 31 st, 2017 at the Newborn Disease Screening Center of Henan Province were assigned as the case group and healthy newborns of the same sex with length of birth less than 30 days as the control group according to 1:1 ratio. Conditional logistic regression and restricted cubic spline analysis were performed to analyze the risk factors of CH. Results A total of 843 pairs of case-control were enrolled in this study. Taking the age group of 21-<26 years as reference, CH risk rose in the advanced delivery age groups of 26-<31 years, 31-<35 years, and ≥35 years(ORadj=2.724, 95%CI: 1.868-3.928;ORadj=6.845, 95%CI: 4.136-11.372;ORadj=7.713, 95%CI: 4.168-14.274). In addition, living in the rural area(ORadj=1.577, 95%CI: 1.090-2.281), family history of thyroid diseases(ORadj=9.574, 95%CI: 3.462-26.750), exposure to formaldehyde(ORadj=7.322, 95%CI: 2.967-18.066),exposure to radiation(ORadj=7.663, 95% CI: 2.521-23.293), medicine intake during pregnancy including antibiotics,antipyretics, NSAIDs(ORadj=8.837, 95%CI: 4.325-18.203), lower education level(ORadj=3.658, 95%CI: 2.464-5.431), and progesterone intake during pregnancy(ORadj=0.159, 95% CI: 0.076-0.333) were associated with of CH. The risk of CH in newborns increased as maternal age advanced. Conclusion Exposure to formaldehyde and radiation, medicine intake during pregnancy, family history of thyroid diseases, living in the rural, lower education level and advanced delivery age are risk factors of CH.

关 键 词：先天性甲状腺功能减低症 病例-对照研究 限制性立方样条分析 

分 类 号：R722.1[医药卫生—儿科]