Thilly C H, Delange F, Lagasse R, Bourdoux P, Ramioul L, Berquist H, Ermans A M
J Clin Endocrinol Metab. 1978 Aug;47(2):354-60. doi: 10.1210/jcem-47-2-354.
The relationship between maternal thyroid function and newborn thyroid function was studied in a region of very severe endemic goiter (Ubangi, Republic of Zaïre). T4, T3, and TSH concentrations were measured in the sera of 56 mothers (at the time of delivery) and 60 newborns (in the cord). The results obtained in these groups (untreated) were compared with those obtained in two control groups, comprising 53 mothers whose iodine deficiency had been corrected by the injection of iodized oil and 68 neonates born to such mothers. The results show that the mean (+/- SEM) T4 serum concentration (micrograms per dl) was 11.5 +/- 0.7 in the untreated mothers compared with 15.7 +/- 0.7 in the treated mothers (P less than 0.001), and 9.4 +/- 0.8 in the untreated newborns compared with 12.4 +/- 0.5 in the newborns of treated mothers (P less than 0.01). The values observed for the mean T3 serum concentrations (nanograms per dl) in the same groups were 171 +/- 10 and 154 +/- 9 (mothers; P greater than 0.05) and 68 +/- 6 and 55 +/- 6 (newborns; P greater than 0.05); the mean TSH serum concentrations (microunits per ml) were 8.7 (7.6 - 9.9) and 5.4 (4.9 - 5.9; mothers; P less than 0.001) and 19.6 (16.6 - 23.2) and 6.4 (5.8 - 7.0; newborns; P less than 0.001). The proportion of untreated newborns, i.e. 40%, with individual TSH values deviating by more than 2 SDS above the mean of the treated newborns is much greater than the corresponding proportion, i.e. 15%, of untreated mothers in relation to the treated ones. In 6 out of 34 untreated newborns, definite biochemical signs of congenital hypothyroidism were observed. Correlation coefficients were calculated between the untreated subjects. A positive correlation coefficient of 0.80 (P less than 0.001) was observed between the serum T4 concentrations of the mothers and those of the newborns, and one of 0.61 (P less than 0.001) was observed between their respective serum TSH values. Significant inverse correlations were observed between maternal serum T4 and cord serum TSH (-0.79; P less than 0.001) and between cord T4 concentrations and maternal TSH concentrations (-0.57; P less than 0.01). No definite trend is observed between the variations of serum T3 on one hand, and those of serum T4 or serum TSH on the other hand. Out of 51 mothers in whom serum T4 was determined, 11 showed values below 8 micrograms /dl; the newborns of those mothers showed very low serum T4 values (5.5 +/- 1.6 micrograms/100 ml) and extremely high serum TSH levels [144 (98-210) microU/ml]. It is concluded that, contrary to the situation observed in physiological conditions, maternal thyroid function in regions of severe endemic goiter is a good indicator of newborn thyroid function. The reasons for this probably lie in the influence of environmental factors acting simultaneously on the mother and the fetus.
在扎伊尔共和国乌班吉地区这个非常严重的地方性甲状腺肿流行区，对母亲甲状腺功能与新生儿甲状腺功能之间的关系进行了研究。测定了56名母亲（分娩时）和60名新生儿（脐带血）血清中的T4、T3和TSH浓度。将这些未治疗组的结果与两个对照组的结果进行比较，其中一个对照组由53名通过注射碘化油纠正了碘缺乏的母亲组成，另一个对照组由68名这些母亲所生的新生儿组成。结果显示，未治疗母亲的血清T4平均（±SEM）浓度（微克/分升）为11.5±0.7，而治疗母亲的为15.7±0.7（P＜0.001）；未治疗新生儿的为9.4±0.8，而治疗母亲所生新生儿的为12.4±0.5（P＜0.01）。同一组中血清T3平均浓度（纳克/分升）的值分别为171±10和154±9（母亲；P＞0.05）以及68±6和55±6（新生儿；P＞0.05）；血清TSH平均浓度（微单位/毫升）分别为8.7（7.6 - 9.9）和5.4（4.9 - 5.9；母亲；P＜0.001）以及19.6（16.6 - 23.2）和6.4（5.8 - 7.0；新生儿；P＜0.001）。未治疗新生儿中，个体TSH值高于治疗新生儿均值2个标准差以上的比例为40%，远高于未治疗母亲相对于治疗母亲的相应比例（15%）。在34名未治疗新生儿中，有6名观察到了先天性甲状腺功能减退的确切生化迹象。计算了未治疗受试者之间的相关系数。母亲血清T4浓度与新生儿血清T4浓度之间观察到正相关系数为0.80（P＜0.001），其各自血清TSH值之间为0.61（P＜0.001）。在母亲血清T4与脐带血清TSH之间（-0.79；P＜0.001）以及脐带T4浓度与母亲TSH浓度之间（-0.57；P＜0.01）观察到显著的负相关。一方面血清T3的变化与另一方面血清T4或血清TSH的变化之间未观察到明确趋势。在测定了血清T4的51名母亲中，有11名的值低于8微克/分升；这些母亲的新生儿血清T4值非常低（5.5±1.6微克/100毫升），血清TSH水平极高[144（98 - 210）微单位/毫升]。得出的结论是，与生理状况下观察到的情况相反，在严重地方性甲状腺肿流行区，母亲的甲状腺功能是新生儿甲状腺功能的一个良好指标。其原因可能在于同时作用于母亲和胎儿的环境因素的影响。
