Miyamoto N, Tsuji M, Imataki T, Nagamachi N, Hirose S, Hamada Y
Department of Pediatrics, Zentsuji National Hospital, Kagawa, Japan.
Acta Paediatr Jpn. 1991 Jun;33(3):363-8. doi: 10.1111/j.1442-200x.1991.tb01567.x.
We measured the cord serum levels of thyroid-stimulating hormone (TSH), thyroxine (T4) and triiodothyronine (T3) in 922 neonates delivered by mothers who had no thyroid disorders. The T4 and T3 levels increased progressively from the 27th to the 40th week of gestation. However, the TSH levels varied widely and had no correlation with gestational age, because they were affected by the mode of delivery. The mean cord serum TSH level in neonates delivered by vacuum extraction was 16.3 +/- 10.0 microU/ml (n = 30), which was significantly higher than the level following normal vaginal delivery (9.5 +/- 6.0 microU/ml, n = 622) (p less than 0.005). The mean cord serum TSH level following elective caesarean section was 6.5 +/- 3.1 microU/ml (n = 79), and this was significantly lower than after normal vaginal delivery (p less than 0.005). TSH levels in high-risk neonates were significantly higher than in neonates without risk factors. A significant positive correlation was found between the duration of the second stage of labor and the cord serum TSH level (r = 0.45, n = 412, p less than 0.01). However, there was no correlation between the cord serum TSH level and the congenital hypothyroidism screening TSH level (r = 0.01, n = 468). We conclude that the cord serum TSH level reflects delivery stress and that an elevated level does not influence the congenital hypothyroidism screening TSH test in which blood is obtained at five days of life.
我们检测了922例母亲无甲状腺疾病的新生儿的脐带血清促甲状腺激素（TSH）、甲状腺素（T4）和三碘甲状腺原氨酸（T3）水平。T4和T3水平在妊娠第27周至第40周逐渐升高。然而，TSH水平差异很大，且与胎龄无关，因为它们受分娩方式影响。经真空吸引分娩的新生儿脐带血清TSH平均水平为16.3±10.0 μU/ml（n = 30），显著高于正常阴道分娩后的水平（9.5±6.0 μU/ml，n = 622）（p<0.005）。择期剖宫产术后脐带血清TSH平均水平为6.5±3.1 μU/ml（n = 79），显著低于正常阴道分娩后（p<0.005）。高危新生儿的TSH水平显著高于无危险因素的新生儿。第二产程持续时间与脐带血清TSH水平之间存在显著正相关（r = 0.45，n = 412，p<0.01）。然而，脐带血清TSH水平与先天性甲状腺功能减退症筛查TSH水平之间无相关性（r = 0.01，n = 468）。我们得出结论，脐带血清TSH水平反映分娩应激，且升高的水平不影响出生后五天采血的先天性甲状腺功能减退症筛查TSH检测。
