Fuse Y, Wakae E, Nemoto Y, Uga N, Tanaka M, Maeda M, Tada H, Miyachi Y, Irie M
Department of Neonatology, Toho University, School of Medicine, Tokyo, Japan.
Endocrinol Jpn. 1991 Jun;38(3):297-302. doi: 10.1507/endocrj1954.38.297.
To evaluate the effect of perinatal factors and sampling methods on thyroid stimulating hormone (TSH) and thyroid hormone levels in cord blood, serum TSH, free thyroxine (FT4) and free triiodothyronine (FT3) concentrations were measured in 124 healthy term neonates. Eighty-eight infants were born in normal vaginal deliveries, 25 were delivered by vacuum extractor and 11 by Cesarean section. There was no significant difference among the three infant groups in the mean TSH levels. Birth weight, the infant's sex, duration of labor and uterotonic agents had no effect on cord serum TSH and free thyroid hormone levels in the neonates born by normal vaginal delivery. To assess the adequacy of specimen collection, mixed cord blood samples, obtained by a direct application of cord on a filter paper, and venous blood withdrawn with a plastic syringe were collected in another 200 infants. There was a significant linear correlation in the TSH concentration in mixed cord blood and cord venous serum from the same individuals, while a poor correlation was found in T4 values from two specimens. Our results suggest that the TSH value in cord blood is less influenced by perinatal factors, including the sampling method, and the mixed cord blood collected by this technique might be a feasible alternative specimen for a TSH screening program with cord blood which is useful in countries where neonatal blood is not available.
为评估围产期因素及采样方法对脐血中促甲状腺激素（TSH）和甲状腺激素水平的影响，对124例足月健康新生儿测定了血清TSH、游离甲状腺素（FT4）和游离三碘甲状腺原氨酸（FT3）浓度。88例婴儿经正常阴道分娩出生，25例通过真空吸引器助产，11例剖宫产。三组婴儿的平均TSH水平无显著差异。出生体重、婴儿性别、产程及宫缩剂对经正常阴道分娩出生的新生儿脐血TSH和游离甲状腺激素水平无影响。为评估标本采集的充分性，在另外200例婴儿中采集了通过将脐带直接置于滤纸上获得的混合脐血样本以及用塑料注射器抽取的静脉血。同一人混合脐血和脐静脉血清中的TSH浓度存在显著线性相关，而两个标本的T4值相关性较差。我们的结果表明，脐血中的TSH值受围产期因素（包括采样方法）的影响较小，并且通过该技术采集的混合脐血可能是用于脐血TSH筛查项目的可行替代标本，这在无法获取新生儿血液的国家很有用。
