Smit B J, Kok J H, Vulsma T, Briët J M, Boer K, Wiersinga W M
Department of Neonatology, Academic Medical Center, University of Amsterdam and Emma Children's Hospital AMC, The Netherlands.
Acta Paediatr. 2000 Mar;89(3):291-5.
A prospective observational study was performed in pregnant women with known thyroid disease. We studied the effect of maternal thyroid function in the first half of pregnancy on the neurologic development of the infant in the first 2 y of life. Clinical and thyroid function data were collected from 20 pregnant women with known thyroid disease and their newborn children. Infants were divided into three groups according to their maternal thyroid function within the first half of pregnancy: Group A (n = 7): maternal subclinical hypothyroidism, Group B (n = 6): maternal euthyroidism, and Group C (n = 7): maternal hyperthyroidism or subclinical hyperthyroidism. Neurophysiologic, i.e. motor nerve conduction velocity and somatosensory evoked potentials and neurologic and developmental (Bayley scales) assessments were done. One infant, born to a mother with Graves' disease, developed transient hyperthyroidism. At the age of 6 and 12 mo, the mean mental developmental index (MDI) score was 16 points lower for infants in Group A than for those in Group B (p = 0.03 and 0.02, respectively). At the age of 24 mo, the mean MDI score was 6 points lower, which was not statistically significant. Neurophysiologic and neurologic assessments and the mean Psychomotor Developmental scores did not differ among the three groups. In conclusion, maternal subclinical hypothyroidism in the first half of pregnancy was associated with a lower mean MDI score in their infants during the first year of life.
对患有已知甲状腺疾病的孕妇进行了一项前瞻性观察研究。我们研究了妊娠前半期母亲甲状腺功能对婴儿出生后头2年神经发育的影响。收集了20名患有已知甲状腺疾病的孕妇及其新生儿的临床和甲状腺功能数据。根据婴儿母亲妊娠前半期的甲状腺功能，将婴儿分为三组：A组（n = 7）：母亲亚临床甲状腺功能减退；B组（n = 6）：母亲甲状腺功能正常；C组（n = 7）：母亲甲状腺功能亢进或亚临床甲状腺功能亢进。进行了神经生理学评估，即运动神经传导速度和体感诱发电位，以及神经学和发育（贝利量表）评估。一名患有格雷夫斯病母亲所生的婴儿出现了短暂性甲状腺功能亢进。在6个月和12个月时，A组婴儿的平均智力发育指数（MDI）得分比B组婴儿低16分（分别为p = 0.03和0.02）。在24个月时，平均MDI得分低6分，但无统计学意义。三组之间的神经生理学和神经学评估以及平均心理运动发育得分没有差异。总之，妊娠前半期母亲亚临床甲状腺功能减退与婴儿出生后第一年较低的平均MDI得分有关。
