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早产短暂性甲状腺素血症与成年早期神经发育结局之间无关联。

No Association Between Transient Hypothyroxinemia of Prematurity and Neurodevelopmental Outcome in Young Adulthood.

作者信息

Hollanders Jonneke J, Israëls Joël, van der Pal Sylvia M, Verkerk Paul H, Rotteveel Joost, Finken Martijn J J

机构信息

Department of Pediatrics (J.J.H., J.I., J.R., M.J.J.F.), VU University Medical Center, 1007 MB Amsterdam, The Netherlands; and Netherlands Organization for Applied Scientific Research (S.M.v.d.P., P.H.V.), Child Health, 2316 ZL Leiden, The Netherlands.

出版信息

J Clin Endocrinol Metab. 2015 Dec;100(12):4648-53. doi: 10.1210/jc.2015-3078. Epub 2015 Oct 19.

Abstract

CONTEXT

Transient hypothyroxinemia of prematurity (THoP) has been associated with neurodevelopmental impairment in infancy and childhood. It is not known whether these relations persist into adulthood.

OBJECTIVE

The objective was to examine whether there is an effect of THoP on intelligence quotient (IQ) score and motor functioning at a young adult age.

DESIGN

This study was part of the 19-year follow-up of the Project On Preterm and Small-for-gestational-age birth (POPS) cohort, which included infants born very preterm (ie, <32 wk) and/or with a very low birth weight (ie, <1500 g).

SETTING

This was a multicenter study.

PATIENTS

There were 398 19-year-old participants of the POPS cohort, of whom 120 had THoP.

EXPOSURE

T4 concentrations were obtained through the national neonatal screening program for congenital hypothyroidism. THoP was defined as a total T4 concentration < -3 SD of the daily mean (approximately 60 nmol/L).

MAIN OUTCOME MEASURES

Main outcome measures were IQ and motor functioning, measured with the digital Multicultural Capacities Test-Intermediate Level and a revised version of Touwen's examination of minor neurological dysfunction, respectively.

RESULTS

THoP was not associated with IQ score (mean difference, 0 [95% confidence interval, -3.8 to 3.8] points) or motor function (mean difference, 0.6 [95% confidence interval, -1.3 to 2.5] points) after adjustment for demographic and perinatal characteristics.

CONCLUSIONS

No associations between THoP and neurodevelopmental outcome at age 19 years were found.

摘要

背景

早产儿短暂性甲状腺素血症(THoP)与婴幼儿期的神经发育障碍有关。目前尚不清楚这些关联是否会持续到成年期。

目的

研究THoP对年轻成年人智商(IQ)得分及运动功能是否有影响。

设计

本研究是早产及小于胎龄儿出生项目(POPS)队列19年随访研究的一部分,该队列纳入了极早产儿(即<32周)和/或极低出生体重儿(即<1500g)。

地点

这是一项多中心研究。

患者

POPS队列中有398名19岁参与者,其中120人患有THoP。

暴露因素

通过全国先天性甲状腺功能减退症新生儿筛查项目获取甲状腺素(T4)浓度。THoP定义为总T4浓度低于每日均值的-3标准差(约60nmol/L)。

主要结局指标

主要结局指标分别为IQ和运动功能,采用数字多元文化能力测试中级水平和修订版的图温小儿神经功能障碍检查进行测量。

结果

在对人口统计学和围产期特征进行调整后,THoP与IQ得分(平均差值为0[95%置信区间为-3.8至3.8]分)或运动功能(平均差值为0.6[95%置信区间为-1.3至2.5]分)无关。

结论

未发现THoP与19岁时的神经发育结局之间存在关联。

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