Radetti G, Gentili L, Paganini C, Oberhofer R, Deluggi I, Delucca A
Department of Pediatrics, Regional Hospital of Bolzano, Italy.
Minerva Pediatr. 2000 Dec;52(12):691-8.
To investigate the frequency and the effects of various degrees of maternal thyroid dysfunction in the first trimester of pregnancy, before the onset of fetal thyroid function, on psychomotor and audiological outcome of the offspring.
In a cohort of 691 pregnant women, undergoing thyroid screening between the 8th and 10th gestational week, eight were found to have a subclinical form of hypothyroidism and one was frankly hypothyroid. Treatment with L-thyroxine was started soon after diagnosis was made. Their nine offspring had a psychomotor and audiological assessment at the age of nine months. Psychomotor development was evaluated with the Brunet-Lèzine test, while audiological function was assessed with auditory brainstem responses (ABR's).
Psychomotor developmental quotients were not different in patients and controls (99 +/- 6 vs 101 +/- 4). Regarding ABR pattern, there were no significant differences between patients and controls. Moreover, no correlation was found between maternal fT4 and psychomotor as well as audiological outcome in the offspring.
These findings are reassuring, since various degrees of maternal thyroid dysfunction in early pregnancy seem to have no adverse effects on the psychomotor and audiological outcome of the offspring up to nine months of age. A longer follow-up however is needed before definitive statements can be made.
调查妊娠早期胎儿甲状腺功能开始之前各种程度的母体甲状腺功能障碍的发生频率及其对后代精神运动和听力结果的影响。
在一组691名妊娠8至10周接受甲状腺筛查的孕妇中，发现8例为亚临床甲状腺功能减退，1例为明显甲状腺功能减退。诊断后不久即开始用左旋甲状腺素治疗。他们的9名后代在9个月大时进行了精神运动和听力评估。精神运动发育用布鲁内-勒津测试进行评估，听力功能用听觉脑干反应（ABR）进行评估。
患者和对照组的精神运动发育商没有差异（99±6对101±4）。关于ABR模式，患者和对照组之间没有显著差异。此外，在母体游离甲状腺素与后代的精神运动以及听力结果之间未发现相关性。
这些发现令人安心，因为妊娠早期各种程度的母体甲状腺功能障碍似乎对9个月大之前的后代精神运动和听力结果没有不利影响。然而，在做出明确结论之前需要更长时间的随访。
