Zhou Jinfu, Luo Jinying, Zhao Hong, Wang Jing, Lin Feng, Zhang Honghua, Su Yueqing, Chen Yao, Zeng Yinglin, Lin Qingying, Zhu Wenbin
Fujian Provincial Maternity and Child Care Hospital, Teaching Hospital of Fujian Medical University, Fujian Neonatal Screening Center, Fuzhou 350001, China.
Department of Women Health Care, Fuzhou 350001, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2015 Jul;36(7):747-51.
To understand the relationship between perinatal factors and congenital hypothyroidism (CH) and provide scientific evidence for the prevention of CH.
A case-control study was conducted among 125 neonates with CH (case group) and 375 neonates without CH (control group) in Fujian Neonatal Screening Center from January in 2012 to December in 2013. Univariate and multivariate logistic regression analysis were performed to identify the risk factors to CH during perinatal period.
Univariate logistic regression analysis indicated that compared with control group, gestational hypertension, gestational diabetes mellitus, gestational thyroid disease and older age of mother were the risk factors to CH, the difference was statistically significant (P < 0.05) and the risk of CH was higher in female babies, preterm babies, post-term babies low birth weight babies, macrosomia, twins, babies with birth defects and infection in cases group than those in control group, the difference was statistically significant (P < 0.05). Multivariate logistic analysis showed that older age of mother (OR = 2.518, 95% CI: 1.186-5.347), gestational diabetes mellitus (OR = 1.904, 95% CI: 1.190-3.045), gestational hypothyroidism or hyperthyroidism (OR = 12.883 and 30.797, 95% CI: 2.055-80.751 and 3.309-286.594), preterm birth (OR = 4.238, 95% CI: 1.269-14.155), and post-term birth (OR = 12.799, 95% CI: 1.257-130.327), low birth weight (OR = 3.505, 95% CI: 1.059-11.601), macrosomia (OR = 3.733, 95% CI: 1.415-9.851), twin or multiparous delivery (OR = 5.493, 95% CI: 1.701-17.735), birth defects (OR = 3.665, 95% CI: 1.604-8.371) and fetal distress (OR = 3.130, 95% CI: 1.317-7.440) were the high risk factors to CH (P < 0.05).
CH was correlated with mother's age, gestational diabetes, gestational thyroid disease as well as neonate's birth weight and gestational age, foetus number, fetal distress and other complicated birth defects at certain degree. More attention should be paid to perinatal care to reduce risk factors and the incidence of CH.
了解围产期因素与先天性甲状腺功能减退症(CH)之间的关系,为CH的预防提供科学依据。
2012年1月至2013年12月在福建省新生儿筛查中心对125例CH新生儿(病例组)和375例无CH新生儿(对照组)进行病例对照研究。采用单因素和多因素logistic回归分析确定围产期CH的危险因素。
单因素logistic回归分析显示,与对照组相比,妊娠期高血压、妊娠期糖尿病、妊娠期甲状腺疾病及母亲年龄较大是CH的危险因素,差异有统计学意义(P<0.05);病例组女婴、早产儿、过期产儿、低体重儿、巨大儿、双胎、出生缺陷儿及感染儿患CH的风险高于对照组,差异有统计学意义(P<0.05)。多因素logistic分析显示,母亲年龄较大(OR=2.518,95%CI:1.186-5.347)、妊娠期糖尿病(OR=1.904,95%CI:1.190-3.045)、妊娠期甲状腺功能减退或亢进(OR=12.883和30.797,95%CI:2.055-80.751和3.309-286.594)、早产(OR=4.238,95%CI:1.269-14.155)、过期产(OR=12.799,95%CI:1.257-130.327)、低体重(OR=3.505,95%CI:1.059-11.601)、巨大儿(OR=3.733,95%CI:1.415-9.851)、双胎或多胎分娩(OR=5.493,95%CI:1.701-17.735)、出生缺陷(OR=3.665,95%CI:1.604-8.371)和胎儿窘迫(OR=3.130,95%CI:1.317-7.440)是CH的高危因素(P<0.05)。
CH与母亲年龄、妊娠期糖尿病、妊娠期甲状腺疾病以及新生儿出生体重、孕周、胎儿数、胎儿窘迫和其他复杂出生缺陷在一定程度上相关。应更加重视围产期保健,以降低危险因素和CH的发病率。