Stagnaro-Green Alex, Chen Xinhua, Bogden John D, Davies Terry F, Scholl Theresa O
Department of Medicine, UMDNJ-New Jersey Medical School, Division of Endocrinology and Metabolism, 185 South Orange Avenue, Newark, NJ 17101-6035, USA.
Thyroid. 2005 Apr;15(4):351-7. doi: 10.1089/thy.2005.15.351.
The major cause of neonatal mortality and morbidity is preterm delivery in general (< 37 completed weeks), and especially very preterm delivery (< 32 completed weeks). The objective of this study is to determine if either thyroid hormonal dysfunction and/or the presence of thyroid autoantibodies in the mother are associated with an increased risk of preterm and/or very preterm delivery. Data were collected prospectively and analyzed as a nested-case control study. There were 953 delivered gravidas enrolled between 1996 and 2002. Samples were collected at entry to care and stored at -70 degrees C. Cases included all women with preterm delivery (n = 124). Controls (n = 124) were randomly selected from among the 829 women who delivered at term (> 37 completed weeks). All samples were assessed for thyroid stimulating hormone, thyroperoxidase antibody, and thyroglobulin antibody. Gravidas with high thyrotropin (TSH) levels had a greater than threefold increase in risk of very preterm delivery. In some analyses, gravidas who tested positive for thyroglobulin antibody at entry to prenatal care also had a better than twofold increased risk of very preterm delivery. There were no significant associations between TSH level or thyroglobulin antibody positivity and the risk of moderately preterm delivery.
一般来说，新生儿死亡和发病的主要原因是早产（<37足周），尤其是极早产（<32足周）。本研究的目的是确定母亲甲状腺功能障碍和/或甲状腺自身抗体的存在是否与早产和/或极早产风险增加有关。前瞻性收集数据并作为巢式病例对照研究进行分析。1996年至2002年间纳入了953例分娩孕妇。在开始护理时采集样本并储存在-70℃。病例包括所有早产妇女（n = 124）。对照组（n = 124）从829例足月分娩（>37足周）的妇女中随机选取。对所有样本进行促甲状腺激素、甲状腺过氧化物酶抗体和甲状腺球蛋白抗体检测。促甲状腺激素（TSH）水平高的孕妇极早产风险增加超过三倍。在一些分析中，产前护理开始时甲状腺球蛋白抗体检测呈阳性的孕妇极早产风险也增加超过两倍。TSH水平或甲状腺球蛋白抗体阳性与中度早产风险之间无显著关联。
