新生儿高促甲状腺素血症与妊娠期甲状腺功能关系的病例对照研究  

Relationship between neonatal hyperthyrotropinemia and maternal thyroid function during pregnancy:a case-control study

作　　者：齐志业[1,2] 张彩营[1] 王琼[2] 赵小龙 奎正平 侯晓梅[3] QI Zhiye;ZHANG Caiying;WANG Qiong;ZHAO Xiaolong;KUI Zhengping;HOU Xiaomei(l.Department of Pediatrics,The First Af filiated Hospital of Kunming Medical University,Yunnan Kunming 650032,China;Sereening Centerof Neonatal Hereditary and Metabolic Diseases,The First Af filiated Hospital of Kunming Medical University,Yunnan Kunming 650032,China;Department of Obstetrics,The First Af filiated Hospital of Kunming Medical University,Yunnan Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院儿科,云南昆明650032 [2]昆明医科大学第一附属医院新生儿遗传代谢病筛查中心,云南昆明650032 [3]昆明医科大学第一附属医院产科,云南昆明650032

出　　处：《中国妇幼健康研究》2022年第8期1-5,共5页Chinese Journal of Woman and Child Health Research

基　　金：云南省科技厅科技计划项目(202101AY070001-099)。

摘　　要：目的 探讨新生儿高促甲状腺素血症(HT)与母亲妊娠期甲状腺功能的关系。方法 选择2016至2020年于我院遗传代谢病筛查中促甲状腺素(TSH)筛查阳性并完成甲状腺功能检查的新生儿为研究对象,其中诊断为HT的新生儿为病例组,甲状腺功能检查正常的新生儿为对照组。采用单因素和二元Logistic回归模型分析新生儿HT与母亲妊娠期甲状腺功能的关系。结果 单因素分析结果显示,病例组母亲高龄、妊娠期TPOAb增高、新生儿早产和胎儿宫内窘迫的发生率高于对照组,差异均有统计学意义(χ^(2)值分别是6.564、8.675、8.675、4.042,P<0.05)。相关分析显示妊娠期TSH和TPOAb存在正相关关系(r=0.188,P=0.005)。二元Logistic回归分析显示,母亲妊娠期TSH增高(OR=2.480,95%CI:1.116~5.531)和TPOAb增高者(OR=3.039,95%CI:1.385~6.668)其新生儿发生HT的风险较高。结论 母亲妊娠期TSH和TPOAb增高可增加新生儿HT的发生风险。积极治疗妊娠期甲状腺疾病是预防新生儿HT的重要手段。Objective To investigate relationship between neonatal hyperthyrotropinemia(HT) and maternal thyroid function during pregnancy.Methods A case-control study was conducted. 102 newborns with positive HT screening result(case group) and 122 newborns without HT(control group) and their mothers who received thyroid function examination during pregnancy in Screening Center of Neonatal Hereditary and Metabolic Diseases of The First Affiliated Hospital of Kunming Medical University from 2016 to 2020 were selected as study subjects.Univariate and multivariate Logistic regression analyses were conducted to analyze relationship between neonatal HT and maternal thyroid function during pregnancy.Results Univariate analysis showed that the proportion of advanced maternal age, the incidence rates of increased thyroid peroxidase antibody(TPOAb) during pregnancy, premature birth of the newborn and fetal intrauterine distress in the case group was significantly higher than those in the control group(χ^(2)=6.564,8.675,8.675 and 4.042 respectively, all P<0.05).Correlation analysis showed that there was a positive correlation between thyroid-stimulating hormone(TSH) and TPOAb during pregnancy(r=0.188,P=0.005).Bivariate logistic regression analysis showed that increased maternal serum TSH(OR=2.480,95%CI:1.116-5.531) and TPOAb levels(OR=3.039,95%CI:1.385-6.668) during pregnancy were the independent risk factors for neonatal HT.Conclusion Maternal high serum TSH and TPOAb levels during pregnancy increase the risk of neonatal HT.Active treatments of maternal thyroid disorders during pregnancy is an important means to prevent neonatal HT.

关 键 词：新生儿 高促甲状腺素血症 甲状腺功能 妊娠期 病例对照研究 

分 类 号：R174.6[医药卫生—妇幼卫生保健]