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患有自身免疫性甲状腺疾病的母亲所生早期婴儿原发性甲状腺功能障碍的危险因素。

Risk factors of primary thyroid dysfunction in early infants born to mothers with autoimmune thyroid disease.

作者信息

Fu Junfen, Jiang Youjun, Liang Li, Zhu Hong

机构信息

Department of Endocrinology, The Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Acta Paediatr. 2005 Aug;94(8):1043-8. doi: 10.1111/j.1651-2227.2005.tb02043.x.

Abstract

AIM

To assess whether the state of maternal thyroid function and the pattern of thyroid alterations during gestation would affect the infants' thyroid function and to evaluate the risk factors affecting early infants' thyroid function by means of multiple logistic regression.

METHODS

In a cross-sectional study, 78 neonates born to mothers with Graves disease or Hashimoto thyroiditis were examined and followed clinically and biochemically. Neonates born to healthy mothers during the same period were set as controls. Tests of thyroid function, antithyroid peroxidase antibody (TPOAb), antithyroglobulin antibody (TGAb), anti-TSH receptor antibody (TRAb) and antithyroid-stimulating antibody (TSAb) were performed both in early infants and their mothers. All possible maternal and/or infantile risk factors for thyroid dysfunction during early infancy were analysed by means of multiple-factor logistical regression.

RESULTS

The overall prevalence of underlying subtle thyroid abnormalities in these 78 infants was 52.6%, which was significantly higher than that witnessed among infants from healthy mothers (5.4 per thousand, p<0.01). By using multiple logistic regression analysis, the state of maternal thyroid function in gestation, the type of autoimmune thyroid disease during pregnancy and the level of TRAb in the newborn were significantly correlated with the early infants' thyroid dysfunction.

CONCLUSION

Maternal autoimmune thyroid disease during pregnancy will affect infant thyroid function. Therefore, appropriate management of maternal autoimmune thyroid disease throughout pregnancy is essential in the prevention of undesirable neonatal outcomes.

摘要

目的

评估孕期母亲甲状腺功能状态及甲状腺变化模式是否会影响婴儿甲状腺功能,并通过多因素logistic回归分析评估影响早期婴儿甲状腺功能的危险因素。

方法

在一项横断面研究中,对78例患有Graves病或桥本甲状腺炎母亲所生的新生儿进行临床和生化检查及随访。同期健康母亲所生的新生儿作为对照。对早期婴儿及其母亲进行甲状腺功能、抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)、抗促甲状腺激素受体抗体(TRAb)和抗甲状腺刺激抗体(TSAb)检测。通过多因素logistic回归分析所有可能的母亲和/或婴儿期甲状腺功能障碍的危险因素。

结果

这78例婴儿潜在轻微甲状腺异常的总体患病率为52.6%,显著高于健康母亲所生婴儿(千分之5.4,p<0.01)。通过多因素logistic回归分析,孕期母亲甲状腺功能状态、孕期自身免疫性甲状腺疾病类型及新生儿TRAb水平与早期婴儿甲状腺功能障碍显著相关。

结论

孕期母亲自身免疫性甲状腺疾病会影响婴儿甲状腺功能。因此,孕期全程对母亲自身免疫性甲状腺疾病进行适当管理对于预防不良新生儿结局至关重要。

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