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服用甲巯咪唑的甲状腺毒症母亲母乳喂养的儿童的智力发育和甲状腺功能

Intellectual development and thyroid function in children who were breast-fed by thyrotoxic mothers taking methimazole.

作者信息

Azizi Fereidoun, Bahrainian Majid, Khamseh Mohammad E, Khoshniat Mohsen

机构信息

Endocrine Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, I.R. Iran.

出版信息

J Pediatr Endocrinol Metab. 2003 Dec;16(9):1239-43. doi: 10.1515/jpem.2003.16.9.1239.

Abstract

OBJECTIVE

Recent studies have shown normal thyroid function in infants whose mothers receive methimazole (MMI) during breast-feeding. This study evaluates the long-term effect of MMI on thyroid function and intellectual development of such children.

DESIGN AND METHODS

Eighty-two children aged between 48 and 86 months were studied. Forty-two children had been breast-fed while their thyrotoxic lactating mothers received daily doses of MMI 20-30 mg in the first, 10 mg in the second and 5-10 mg for additional 10 months of therapy. Thyroid function of infants remained normal during the one year of MMI therapy of their mothers. Forty other infants served as controls. Serum T4, T3, and TSH concentrations, urinary iodine, thyroid antibodies, intelligence quotient (IQ), verbal and functional (performance) components (Wechsler and Goodenough tests) were measured in all children of the two groups.

RESULTS

Height, weight, serum T4, T3, TSH and antithyroid antibody titers were not different between children in the two groups. The mean IQ was 107 +/- 17 vs 106 +/- 16 (Goodenough test) and 103 +/- 10 vs 103 +/- 16 (Wechsler test) for children of thyrotoxic mothers and control children, respectively. There was no difference in verbal and functional IQ and their components between children of thyrotoxic MMI treated mothers and control children.

CONCLUSION

Thyroid function and physical and intellectual development of breast-fed infants whose thyrotoxic lactating mothers were treated with 20-30 mg doses of MMI daily are normal at age 48 to 86 months.

摘要

目的

近期研究表明,母亲在母乳喂养期间服用甲巯咪唑(MMI)的婴儿甲状腺功能正常。本研究评估MMI对这类儿童甲状腺功能和智力发育的长期影响。

设计与方法

对82名年龄在48至86个月之间的儿童进行了研究。其中42名儿童在其患有甲状腺毒症的哺乳期母亲接受MMI治疗期间进行了母乳喂养,其母亲在治疗的第一个月每日服用20 - 30毫克MMI,第二个月服用10毫克,之后的10个月每日服用5 - 10毫克。在其母亲接受MMI治疗的一年时间里,这些婴儿的甲状腺功能保持正常。另外40名婴儿作为对照。测量了两组所有儿童的血清T4、T3和TSH浓度、尿碘、甲状腺抗体、智商(IQ)、语言和功能(操作)部分(韦氏和古德伊纳夫测试)。

结果

两组儿童的身高、体重、血清T4、T3、TSH和抗甲状腺抗体滴度没有差异。患有甲状腺毒症母亲的儿童和对照儿童的平均智商分别为107±17(古德伊纳夫测试)和106±16,以及103±10(韦氏测试)和103±16。患有甲状腺毒症且接受MMI治疗的母亲的儿童与对照儿童在语言和功能智商及其组成部分方面没有差异。

结论

患有甲状腺毒症的哺乳期母亲每日服用20 - 30毫克MMI进行治疗,其母乳喂养的婴儿在48至86个月时甲状腺功能以及身体和智力发育均正常。

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