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碘充足地区剖宫产术中使用防腐剂与母婴尿碘排泄及新生儿促甲状腺激素的关系

Maternal and neonatal urinary iodine excretion and neonatal TSH in relation to use of antiseptic during caesarean section in an iodine sufficient area.

作者信息

Tahirović Husref, Toromanović Alma, Grbić Sanja, Bogdanović Gordana, Fatusić Zlatan, Gnat Daniella

机构信息

Department of Pediatrics, Division of Endocrinology & Diabetes, University Clinical Center, Tuzla, Bosnia and Herzegovina.

出版信息

J Pediatr Endocrinol Metab. 2009 Dec;22(12):1145-9. doi: 10.1515/jpem.2009.22.12.1145.

DOI:10.1515/jpem.2009.22.12.1145
PMID:20333874
Abstract

AIM

To evaluate the influence of topical iodine-containing antiseptics on neonatal TSH in full-term infants born by Caesarean section in an iodine sufficient area.

POPULATION AND METHODS

Urinary iodide excretion (UIE) was estimated in 86 mothers on the second day after delivery by Caesarean section and their 86 full-term neonates. The mothers were divided into two groups according to the use of antiseptic to prepare Cesarean sections: 42 mothers who were prepared with povidone-iodine (Isosept, Bosnalijek) comprised the study group, and 47 mothers who were prepared with alcoholic solution (Skinsept color, Ecolab) formed the control group. Neonatal TSH was measured in whole blood drawn between day 3 and 5 of life, spotted on filter paper using a sensitive fluorometric assay (Delfia).

RESULTS

Maternal and neonatal UIE were significantly higher (p < 0.05) in the study group compared to the control group. No significant difference was found for neonatal TSH.

CONCLUSION

Our data suggest that perinatal iodine exposure of full-term neonates who were born by Caesarean section in an iodine sufficient area did not influence neonatal TSH, although median UIE was higher, suggesting optimal iodine intake during pregnancy. Further research is needed to define a critical value of urinary iodine concentrations in full-term neonates in an iodine sufficient area that may lead to the impairment of thyroid function.

摘要

目的

评估含碘局部消毒剂对碘充足地区剖宫产出生的足月儿新生儿促甲状腺激素(TSH)的影响。

研究对象与方法

对86例剖宫产术后第二天的母亲及其86例足月儿新生儿进行尿碘排泄量(UIE)评估。根据剖宫产术前使用的消毒剂将母亲分为两组:42例使用聚维酮碘(Isosept,博斯纳利耶克公司)进行术前准备的母亲组成研究组,47例使用酒精溶液(Skinsept color,艺康公司)进行术前准备的母亲构成对照组。在出生后第3至5天采集新生儿全血,采用灵敏的荧光分析法(时间分辨荧光免疫分析法)检测滤纸血斑上的新生儿TSH。

结果

与对照组相比,研究组母亲和新生儿的UIE显著更高(p < 0.05)。新生儿TSH未发现显著差异。

结论

我们的数据表明,在碘充足地区剖宫产出生的足月儿围产期碘暴露虽使UIE中位数更高,提示孕期碘摄入充足,但并未影响新生儿TSH。需要进一步研究来确定碘充足地区足月儿尿碘浓度的临界值,该临界值可能导致甲状腺功能受损。

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