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[母体甲状腺功能亢进及抗甲状腺药物治疗对新生儿甲状腺功能的影响]

[Effects of maternal hyperthyroidism and antithyroid drug therapy on thyroid function of newborn infants].

作者信息

Lian Xiao-lan, Bai Yao, Xun Yun-hua, Dai Wei-xin, Guo Zhi-sheng

机构信息

Department of Endocrinology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2005 Dec;27(6):756-60.

Abstract

OBJECTIVE

To evaluate the relationship between the incidence of abnormal thyroid function of newborns and maternal hyperthyroidism with antithyroid drug therapy.

METHOD

The clinical data of 35 neonates born to mothers with hyperthyroidism from 1983 to 2003 in Peking Union Medical College Hospital were retrospectively analyzed. According to the maternal thyroid function and the antithyroid drugs taken during pregnancy, subjects were divided into different groups.

RESULTS

The proportion of abnormal thyroid function in newborn was 48.6% (17/35). The prevalences of primary hypothyroidism, subclinical hypothyroidism, hypothyroxinemia, and central hypothyroidism were 29.4%, 29.4%, 35.3%, and 5.9%, respectively. The incidence of abnormal thyroid function of neonates whose mothers did not take the antithyroid drugs (ATDs) until the third trimester of pregnancy was significantly higher than those without and with ATDs during the first or second trimester (P < 0.01). The incidence of abnormal thyroid function significantly increased in premature neonates, neonates whose mothers with modest or heavy pregnant hypertension, or neonates whose core serum thyroid-stimulating hormone or serum anti-thyroid peroxidase antibodies levels were abnormal.

CONCLUSION

The risk of abnormal thyroid function of infants whose hyperthyroid mothers did not take ATDs until the third trimester of pregnancy may be increased. Prompt diagnosis and appropriate treatment of hyperthyroidism in pregnant women are essential for the prevention of neonatal thyroid functional abnormality.

摘要

目的

评估新生儿甲状腺功能异常的发生率与母亲甲状腺功能亢进及抗甲状腺药物治疗之间的关系。

方法

回顾性分析1983年至2003年在北京协和医院出生的35例母亲患有甲状腺功能亢进的新生儿的临床资料。根据母亲的甲状腺功能及孕期服用的抗甲状腺药物,将研究对象分为不同组。

结果

新生儿甲状腺功能异常的比例为48.6%(17/35)。原发性甲状腺功能减退、亚临床甲状腺功能减退、低甲状腺素血症和中枢性甲状腺功能减退的患病率分别为29.4%、29.4%、35.3%和5.9%。母亲直到妊娠晚期才服用抗甲状腺药物(ATD)的新生儿甲状腺功能异常的发生率显著高于母亲在妊娠早期或中期未服用及服用ATD的新生儿(P<0.01)。早产新生儿、母亲患有中度或重度妊娠高血压的新生儿或核心血清促甲状腺激素或血清抗甲状腺过氧化物酶抗体水平异常的新生儿甲状腺功能异常的发生率显著增加。

结论

甲状腺功能亢进的母亲直到妊娠晚期才服用ATD,其婴儿甲状腺功能异常的风险可能增加。孕妇甲状腺功能亢进的及时诊断和适当治疗对于预防新生儿甲状腺功能异常至关重要。

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