Kvetny Jan, Poulsen Hedvig
Endocrinological Clinic, Esbjerg County Hospital, Esbjerg, Denmark.
J Matern Fetal Neonatal Med. 2006 Dec;19(12):817-22. doi: 10.1080/14767050600927304.
Although it is well established that maternal thyroid disease and increased levels of thyrotropin receptor antibodies (TRab) during pregnancy are associated with a number of complications, is the significance of increased levels of thyroid peroxidase antibodies (TPOab) alone a matter for discussion? The aim of the present study was to examine whether transplacental passage of TPOab from women with autoimmune thyroid disease (AITD) interferes with thyroid function in the neonate.
Pregnant women with AITD (raised levels of TPOab) and their neonates were monitored with regard to variations of thyroid hormones, thyrotropin (TSH), and TPOab. Pregnant women with non-AITD served as controls.
The neonates from mothers with AITD, independently of the presence also of TRab in the mothers, had a transient hyperthyroxinemia one week following birth. Neonatal TPOab correlated with that of the mothers at gestation and was cleared concomitantly with normalization of thyroxine. A high frequency (21%) of severe hyperbilirubinemia was observed in neonates from mothers with AITD.
Children of mothers with raised levels of TPOab, have a transient hyperthyroxinemia one week after birth accompanied by a high frequency of hyperbilirubinemia suggesting that clinical examination and blood testing should be performed consecutively during the first postnatal week.
虽然孕期母体甲状腺疾病及促甲状腺素受体抗体（TRab）水平升高与多种并发症相关已得到充分证实，但仅甲状腺过氧化物酶抗体（TPOab）水平升高的意义是否值得探讨？本研究的目的是检验自身免疫性甲状腺疾病（AITD）女性的TPOab经胎盘传递是否会干扰新生儿的甲状腺功能。
对患有AITD（TPOab水平升高）的孕妇及其新生儿的甲状腺激素、促甲状腺素（TSH）和TPOab变化进行监测。非AITD孕妇作为对照。
患有AITD的母亲所生的新生儿，无论其母亲是否也存在TRab，在出生后一周均出现短暂的高甲状腺素血症。新生儿TPOab与孕期母亲的TPOab相关，并随着甲状腺素正常化而同时清除。在患有AITD的母亲所生的新生儿中观察到高频率（21%）的严重高胆红素血症。
TPOab水平升高的母亲所生的孩子在出生后一周出现短暂的高甲状腺素血症，并伴有高频率的高胆红素血症，这表明在出生后的第一周应连续进行临床检查和血液检测。
