目的 分析妊娠合并甲状腺功能减退(甲减)对新生儿足跟血促甲状腺激素(TSH)的影响。 方法 2015年4月-2017年4月收集191例妊娠合并甲减孕妇所分娩新生儿作为病例组,9 839例健康孕妇所分娩新生儿作为对照组,于出生72 h后采集足跟血并检测TSH水平。分析可能影响新生儿足跟血TSH的因素,并构建多重线性回归模型分析妊娠合并甲减对新生儿足跟血TSH影响作用。 结果 新生儿足跟血TSH水平与孕妇年龄、分娩孕周、新生儿出生后采血天数、新生儿性别及妊娠是否合并甲减有关,妊娠合并甲减孕妇所分娩的新生儿先天性甲状腺功能减退症(CH)筛查假阳性率显著升高至4.19%;多因素回归分析提示妊娠合并甲减是新生儿足跟血TSH升高的危险因素(β=0.78,95% CI:0.42~1.14,P<0.001)。 结论 妊娠合并甲减是新生儿足跟血TSH水平升高的危险因素,并导致新生儿CH筛查假阳性率显著升高。
Abstract
Objective To analyze the effect of hypothyroidism in pregnancy on thyroid stimulating hormone (TSH) of heel blood in neonates. Methods A total of 191 neonates delivered by pregnant women with hypothyroidism were enrolled in case group, and 9 839 neonates delivered by healthy pregnant women were collected as control group from April 2015 to April 2017.Neonates′ heel blood was collected, and blood levels of TSH were measured.The concomitant variables of neonatal heel blood TSH were screened by univariate analysis, and the effect of hypothyroidism in pregnancy on neonatal TSH level was assessed by multiple linear regression. Results The level of TSH in neonates was associated with maternal age, gestational age, blood collection time after birth, gender and hypothyroidism in pregnancy.The false positive rate of congenital hypothyroidism (CH) screening in neonates delivered by pregnant women with hypothyroidism increased to 4.19% notably.Multifactor analysis showed that hypothyroidism in pregnancy was a risk factor for TSH level increase in neonatal heel blood (β=0.78,95% CI:0.42~1.14,P<0.001). Conclusion Hypothyroidism in pregnancy is a risk factor for TSH level increase in neonatal heel blood, and it may increase the false positive rate of CH screening in neonates.
关键词
妊娠合并甲状腺功能减退症 /
促甲状腺激素 /
先天性甲状腺功能减退症 /
新生儿
Key words
hypothyroidism in pregnancy /
thyroid stimulating hormone /
congenital hypothyroidism /
neonates
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基金
江苏省重点研究计划(社会发展)(BE2017650);江苏省妇幼健康科研项目(F201671);常州市科技支撑计划(社会发展)(CE20175021)。
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