Department of Obstetrics and Gynecology, Oulu University and Oulu University Hospital, Oulu 90029, Finland.
J Clin Endocrinol Metab. 2013 Mar;98(3):965-72. doi: 10.1210/jc.2012-2028. Epub 2013 Feb 13.
Normal maternal thyroid function is important for fetal development. No knowledge exists on how maternal thyroid function and thyroid antibodies during early pregnancy affect thyroid function of the offspring.
The aim of this study was to investigate the relationship between maternal and adolescent thyroid function parameters.
DESIGN, SETTING, AND PARTICIPANTS: A total of 3673 mother-child pairs from the prospective, population-based Northern Finland Birth Cohort 1986 participated in the study. Maternal serum samples were drawn in early pregnancy (<20th gestational week), and children's samples were drawn at the age of 16 years and analyzed for TSH, free T4 (fT4), and thyroid peroxidase antibodies (TPO-Abs).
TSH, fT4, and TPO-Ab concentrations were measured at the age of 16 years. Children of mothers with thyroid dysfunction (hypothyroidism, hyperthyroidism, or hypothyroxinemia) or TPO-Ab positivity were compared to those of euthyroid or TPO-Ab-negative mothers. The distributions are expressed as medians with 5th to 95th percentiles.
Boys of hypothyroid mothers had higher TSH concentrations than those of euthyroid mothers: 2.0 (0.9-4.0) vs 1.7 (0.8-3.3) mU/L; P = .001. Children of hyperthyroid mothers had lower TSH concentrations than those of euthyroid mothers: 1.3 (0.6-4.2) vs 1.7 (0.8-3.3) mU/L, P = .013, for boys; and 1.3 (0.5-3.5) vs 1.6 (0.7-3.4) mU/L, P = .034, for girls. There were no differences in TSH or fT4 concentrations between children of hypothyroxinemic and euthyroid mothers. TPO-Ab-positive mothers more often had TPO-Ab-positive children (prevalence, 9.0 vs 3.7% among boys, and 22.7 vs 7.5% among girls).
Maternal thyroid dysfunction and TPO-Ab positivity during pregnancy seem to modify thyroid function parameters of offspring even in adolescence. Whether this increases the thyroid disease risk of the children is still unknown.
正常的母体甲状腺功能对胎儿发育很重要。目前尚不清楚妊娠早期母体甲状腺功能和甲状腺抗体如何影响后代的甲状腺功能。
本研究旨在探讨母体和青少年甲状腺功能参数之间的关系。
设计、地点和参与者:共有 3673 对母子来自前瞻性、基于人群的 1986 年芬兰北部出生队列研究。在妊娠早期(<20 孕周)采集母体血清样本,在孩子 16 岁时采集样本,检测 TSH、游离 T4(fT4)和甲状腺过氧化物酶抗体(TPO-Ab)。
在 16 岁时测量 TSH、fT4 和 TPO-Ab 浓度。将甲状腺功能障碍(甲状腺功能减退、甲状腺功能亢进或低甲状腺素血症)或 TPO-Ab 阳性母亲的孩子与甲状腺功能正常或 TPO-Ab 阴性母亲的孩子进行比较。分布情况以中位数(5%至 95%位数)表示。
甲状腺功能减退母亲的男孩 TSH 浓度高于甲状腺功能正常的母亲:2.0(0.9-4.0)比 1.7(0.8-3.3)mU/L;P =.001。甲状腺功能亢进母亲的孩子 TSH 浓度低于甲状腺功能正常的母亲:男孩为 1.3(0.6-4.2)比 1.7(0.8-3.3)mU/L,P =.013,女孩为 1.3(0.5-3.5)比 1.6(0.7-3.4)mU/L,P =.034。低甲状腺素血症母亲的孩子 TSH 或 fT4 浓度与甲状腺功能正常的母亲无差异。TPO-Ab 阳性母亲的 TPO-Ab 阳性孩子更常见(男孩中阳性率分别为 9.0%和 3.7%,女孩中分别为 22.7%和 7.5%)。
妊娠期间母体甲状腺功能障碍和 TPO-Ab 阳性似乎会改变后代的甲状腺功能参数,即使在青少年时期也是如此。这是否会增加孩子的甲状腺疾病风险仍不清楚。