Population Health Sciences, Mackenzie Building, University of Dundee, Ninewells Hospital and Medical School Campus, Kirsty Semple Way, Dundee DD2 4BF Scotland, United Kingdom.
J Clin Endocrinol Metab. 2012 Jun;97(6):1977-85. doi: 10.1210/jc.2011-2451. Epub 2012 Apr 4.
Mild maternal thyroid dysfunction during early pregnancy is associated with poor neurodevelopment in affected offspring. Most studies are population based or are smaller populations of term/late preterm infants. No studies were found that focused on more preterm infants.
Our objective was to describe the relationship between mild maternal thyroid dysfunction at delivery of infants born ≤34 wk and neurodevelopment at 5.5 yr.
The study design was follow-up of women and children recruited in Scotland between 1998 and 2001.
We evaluated delivery levels of maternal TSH, free T(4) (FT(4)), and T(4) and the association with McCarthy Scale scores adjusted for 26 confounders of neurodevelopment.
Maternal serum levels and McCarthy scores were available for 143 women and 166 children. After adjustment for confounders, there were significant 3.2, 2.1, and 1.8 point decrements, respectively, in general cognitive index, verbal subscale, and the perceptual performance subscale for each milliunit per liter increment in maternal TSH. Maternal FT(4) levels were variably associated with neurodevelopment. After adjustment, significant associations were found for the general cognitive index, motor scale, and quantitative subscale; each picomole per liter decrease in FT(4) was associated with an increase of 1.5, 1.7, and 0.9 points, respectively. Maternal T(4) levels showed little relationship with neurodevelopment. None of the women in this analysis had overt hypothyroidism, but mild hypothyroidism was evident in 27%; thyroglobulin antibody (TgAb) was ≥ 40 U/ml in 28% of the women.
Higher maternal levels of TSH at delivery of infants born preterm were associated with significantly lower scores on the general cognitive index at 5.5 yr.
妊娠早期轻度母体甲状腺功能障碍与受影响后代的神经发育不良有关。大多数研究都是基于人群的，或者是足月/晚期早产儿的较小人群。没有发现专门针对更早产儿的研究。
我们的目的是描述出生时胎龄≤34 周的婴儿的母亲分娩时轻度甲状腺功能障碍与 5.5 岁时神经发育之间的关系。
该研究设计是对 1998 年至 2001 年间在苏格兰招募的妇女和儿童进行随访。
我们评估了产妇 TSH、游离 T(4)(FT(4))和 T(4)的分娩水平，并对 26 个神经发育混杂因素进行了调整，评估了与 McCarthy 量表评分的关系。
有 143 名妇女和 166 名儿童的血清水平和 McCarthy 评分可用。在校正混杂因素后，母亲 TSH 每增加 1 毫单位/升，一般认知指数、言语分量表和知觉表现分量表分别下降 3.2、2.1 和 1.8 分。母体 FT(4)水平与神经发育呈不同程度相关。调整后，一般认知指数、运动量表和定量量表存在显著关联；FT(4)每减少 1 皮摩尔/升，分别与认知指数、运动量表和定量量表增加 1.5、1.7 和 0.9 分相关。母体 T(4)水平与神经发育关系不大。本分析中没有妇女患有明显的甲状腺功能减退症，但有 27%的妇女存在轻度甲状腺功能减退症；28%的妇女甲状腺球蛋白抗体（TgAb）≥40U/ml。
早产儿出生时母亲的 TSH 水平较高与 5.5 岁时一般认知指数的评分显著降低相关。
