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Effect of small for gestational age on incidence and false-positive screening of congenital hypothyroidism in newborns
- HE Ruixue, SU Xi, HUANG Xiang, CHEN Wenfang
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2025, 33(6):
675-680.
DOI: 10.11852/zgetbjzz2024-0698
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Objective To explore the impact of small for gestational age(SGA) infants on the incidence and screening false positive rate of congenital hypothyroidism(CH) in newborns, in order to provide reference for reducing the incidence of CH and the screening false positive rate. Methods Pregnant women and their newborns who delivered at Foshan Maternity and Child Healthcare Hospital from January 2018 to December 2022 were selected as the study subjects. General information, pregnancy complications, newborn conditions, and blood collection details were collected through the hospital information system. A total of 56 903 pairs of pregnant women and newborns were included in the study and were divided into the SGA group and the control group based on the newborns′ birth weight and gestational age. Thetest was used to compare the differences in general characteristics between the study and control groups. Binary Logistic regression analysis was conducted to assess the impact of SGA infants on the incidence of CH and the false positive rate of CH screening. Results There were significant differences in the proportions of advanced maternal age, anemia during pregnancy, gestational diabetes, gestational hypertension, assisted reproduction, multiple births, low birth weight, and blood collection in winter between SGA infants and control group(χ2=38.38, 34.17, 17.04, 166.04, 5.94, 357.14, 5 328.85, 5.26, P<0.05). After adjusting for confounding factors, thyroid dysfunction during pregnancy was a risk factor for CH in newborns(OR=2.811, 95%CI:1.319 - 5.988, P<0.05). SGA infants(OR=1.253,95%CI:1.103 - 1.423), thyroid dysfunction during pregnancy(OR=2.135, 95%CI: 1.878 - 2.428), female newborns(OR=1.111, 95%CI:1.024 - 1.205), blood collection in winter(OR=1.474, 95%CI: 1.347 - 1.612) were risk factors for false positives in neonatal CH screening(P<0.05),while advanced maternal age(OR=0.874, 95%CI: 0.768 - 0.995), multiple births(OR=0.619, 95%CI: 0.456 - 0.839) and premature birth(OR=0.454, 95%CI: 0.356 - 0.580) were protective factors of false positives in CH screening(P<0.05). Conclusions SGA infants, thyroid dysfunction during pregnancy, female newborns, and blood collection in winter increase the risk of false positives in CH screening. It is recommended to establish different screening thresholds based on the specific conditions of mothers and infants to optimize the utilization of health resources and avoid unnecessary economic and psychological burdens on newborns and their families due to false positives in CH screening.
