Montanelli L, Pinchera A, Santini F, Cavaliere R, Vitti P, Chiovato L
Dipartimento di Endocrinologia e Metabolismo, Ortopedia e Traumatologia, Medicina del Lavoro, Università degli Studi, Pisa.
Ann Ist Super Sanita. 1998;34(3):321-9.
The fetus and the newborn are more sensitive than adults to a reduced environmental iodine supply, and in iodine-deficient areas, transient neonatal hypothyroidism is frequently observed. This transient thyroid failure may be associated with neonatal goiter and elevated serum thyroglobulin levels at birth. Borderline elevated neonatal serum TSH concentrations frequently occur in newborns in iodine deficient areas, and result in a higher recalling rate at the screening for congenital hypothyroidism. Minor defects in mental performances and neurological development are observed in children living in areas of mild to moderate iodine deficiency, and result from the concomitant effects of iodine deficiency in the mother during pregnancy and transient neonatal hypothyroidism. Endemic cretinism is the severe and irreversible neurological consequence of iodine deficiency during fetal and neonatal life. Iodine prophylaxis is highly effective in preventing the development of iodine deficiency disorders including transient neonatal hypothyroidism. Since iodine prophylaxis in Italy is inadequate, variable degrees of iodine deficiency are still present all-over the country, and are responsible of a higher incidence of transient neonatal hypothyroidism or hyperthyrotropinemia.
胎儿和新生儿比成年人对环境碘供应减少更为敏感，在缺碘地区，经常观察到短暂性新生儿甲状腺功能减退。这种短暂性甲状腺功能衰竭可能与新生儿甲状腺肿以及出生时血清甲状腺球蛋白水平升高有关。在缺碘地区的新生儿中，临界性升高的新生儿血清促甲状腺激素（TSH）浓度经常出现，并导致先天性甲状腺功能减退筛查中的召回率较高。在轻度至中度碘缺乏地区生活的儿童中观察到智力表现和神经发育方面的轻微缺陷，这是由于母亲在怀孕期间碘缺乏和短暂性新生儿甲状腺功能减退的共同影响所致。地方性克汀病是胎儿和新生儿期碘缺乏的严重且不可逆的神经后果。碘预防在预防包括短暂性新生儿甲状腺功能减退在内的碘缺乏症的发展方面非常有效。由于意大利的碘预防措施不足，全国各地仍然存在不同程度的碘缺乏，这导致短暂性新生儿甲状腺功能减退或促甲状腺激素血症的发病率较高。
