Kurtoglu Selim, Bastug Osman, Daar Ghaniya, Halis Hulya, Korkmaz Levent, Memur Seyma, Korkut Sabriye, Gunes Tamer, Ozturk Mehmet Adnan
Division of Neonatology, Department of Pediatrics, Erciyes University Medical Faculty, Kayseri, Turkey.
Department of Pediatrics, Bozok University Medical Faculty, Yozgat, Turkey.
Am J Perinatol. 2014 Dec;31(12):1087-92. doi: 10.1055/s-0034-1371701. Epub 2014 Mar 28.
Excessive iodine exposure during the fetal and neonatal periods can lead to neonatal hypothyroidism. This study was conducted to evaluate the level of iodine loading among newborns living in Kayseri province. A total of 59 newborns, who were admitted due to disorders in thyroid hormone levels, were included in the study. Materials and
Among the patients who applied with thyroid hormone dysfunction, newborns with a spot urine iodine level ≥ 20 μg/dL were included in the study between the years 2003 and 2013. Free T3 (fT3), free T4 (fT4), thyroid stimulating hormone (TSH), thyroglobulin (Tg), breast milk iodine, thyroid ultrasonography, and control measurements of fT3, fT4, TSH, and Tg levels were obtained accordingly from both groups of patients who received or did not receive treatment.
The average age of the patients was 15 days with a 36/23 girl to boy ratio. Statistically, no significant difference was noticed between all the girls and boys with respect to all the measured values. The etiologic search showed that out of 59 cases, in 18 cases (30.5%) only the mother and in 19 cases only the newborns (32.2%) had a history of povidone iodine exposure; in 8 cases both mothers and their babies had exposure to povidone iodine (13.6%). In 14 cases (23.7%), the source of iodine loading could not be determined. Levothyroxine (L-thyroxine) treatment was initiated in 56% of the patients (n = 33). Out of 33 patients who were under treatment with L-thyroxine, in 13 cases only the mother had history of povidone iodine exposure; in 12 cases, only the baby had a history of povidone iodine exposure; in 1 case, both mother and her baby had a history of povidone iodine exposure, but the etiology could not be found in 7 cases.
The use of antiseptics-containing iodine for mothers before and after birth and for newborns, especially for umbilical cleansing, can lead to iodine loading and hypothyroidism. If transient hypothyroidism develops within this period, then it may not be detected promptly. This can later lead to retardation in psychomotor development and disorder in learning skills during the childhood period.
胎儿期和新生儿期碘摄入过量可导致新生儿甲状腺功能减退。本研究旨在评估开塞利省新生儿的碘负荷水平。共有59名因甲状腺激素水平紊乱入院的新生儿纳入本研究。
在因甲状腺激素功能障碍前来就诊的患者中,2003年至2013年间,将尿碘水平≥20μg/dL的新生儿纳入研究。分别从接受或未接受治疗的两组患者中获取游离三碘甲状腺原氨酸(fT3)、游离甲状腺素(fT4)、促甲状腺激素(TSH)、甲状腺球蛋白(Tg)、母乳碘、甲状腺超声检查以及fT3、fT4、TSH和Tg水平的对照测量值。
患者的平均年龄为15天,男女比例为36/23。统计学上,所有测量值在所有女孩和男孩之间均未发现显著差异。病因调查显示,59例病例中,18例(30.5%)仅母亲有聚维酮碘暴露史,19例(32.2%)仅新生儿有聚维酮碘暴露史;8例(13.6%)母亲及其婴儿均有聚维酮碘暴露史。14例(23.7%)无法确定碘负荷来源。56%的患者(n = 33)开始使用左甲状腺素(L-甲状腺素)治疗。在33例接受L-甲状腺素治疗的患者中,13例仅母亲有聚维酮碘暴露史;12例仅婴儿有聚维酮碘暴露史;1例母亲及其婴儿均有聚维酮碘暴露史,但7例病因不明。
在分娩前后给母亲以及给新生儿使用含碘消毒剂,尤其是用于脐带清洁时,可导致碘负荷和甲状腺功能减退。如果在此期间发生短暂性甲状腺功能减退,则可能无法及时发现。这随后可能导致儿童期精神运动发育迟缓及学习技能障碍。