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孕期补碘对甲状腺肿流行地区甲状腺功能及出生结局的影响。

Effect of maternal iodine supplementation on thyroid function and birth outcome in goiter endemic areas.

作者信息

Anees Mariam, Anis Riffat Aysha, Yousaf Sohail, Murtaza Iram, Sultan Aneesa, Arslan Muhammad, Shahab Muhammad

机构信息

Department of Biochemistry, Quaid-i-Azam University , Islamabad , Pakistan.

出版信息

Curr Med Res Opin. 2015 Apr;31(4):667-74. doi: 10.1185/03007995.2015.1011779. Epub 2015 Feb 13.

Abstract

OBJECTIVE

The study was undertaken to examine the clinical and endocrine parameters of thyroid in a total of 460 pregnant women belonging to non-goiter areas (group 1; n = 156) and endemic areas without (group 2; n = 154) and with iodine supplementation (group 3; n = 150), and their respective newborns.

METHODS

Women of group 3 with visible goiter were administered two capsules of iodized oil orally each containing 200 mg of iodine, from weeks 6--8 of pregnancy. Blood samples were obtained from all groups during each trimester, at parturition (umbilical cord blood) and after delivery. Serum triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) levels were measured by specific enzyme immunoassays.

RESULTS

In group 2, serum T4 concentrations were low while T3 and TSH levels were high which showed hypothyroidism in the women of endemic areas. Goiter size decreased in most of the subjects who received a single dose of iodized oil and resulted in increase in serum concentrations of thyroid hormones; whereas, TSH levels decreased. Iodine supplementation also resulted in raised T4 and low TSH levels in the cord blood of neonates. During the course of study, two abortions, three still births and one cretin were reported in group 2; none was reported in group 3; and one still birth was reported in group 1.

CONCLUSIONS

The oral administration of a single dose of iodized oil is capable of correcting iodine deficiency both clinically and endocrinologically in mothers and neonates. Iodine supplementation has the potential to positively impact the birth weight of newborns.

摘要

目的

本研究旨在检查460名孕妇及其各自新生儿的甲状腺临床和内分泌参数,这些孕妇分别来自非甲状腺肿流行地区(第1组;n = 156)、无碘补充的甲状腺肿流行地区(第2组;n = 154)和有碘补充的甲状腺肿流行地区(第3组;n = 150)。

方法

第3组中可见甲状腺肿的妇女在妊娠6至8周时口服两粒含碘量为200毫克的碘油胶囊。在每个孕期、分娩时(脐带血)和产后从所有组采集血样。通过特定的酶免疫测定法测量血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)和促甲状腺激素(TSH)水平。

结果

在第2组中,血清T4浓度较低,而T3和TSH水平较高,这表明甲状腺肿流行地区的妇女存在甲状腺功能减退。大多数接受单剂量碘油的受试者甲状腺肿大小减小,导致甲状腺激素血清浓度升高;而TSH水平降低。碘补充也导致新生儿脐带血中T4升高和TSH水平降低。在研究过程中,第2组报告了2例流产、3例死产和1例克汀病;第3组未报告;第1组报告了1例死产。

结论

口服单剂量碘油能够在临床和内分泌方面纠正母亲和新生儿的碘缺乏。碘补充有可能对新生儿出生体重产生积极影响。

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