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正常新生儿中与新生儿促甲状腺激素相关的围产期因素。

Perinatal factors associated with neonatal thyroid-stimulating hormone in normal newborns.

作者信息

Lee Seong Yong

机构信息

Department of Pediatrics, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.

出版信息

Ann Pediatr Endocrinol Metab. 2016 Dec;21(4):206-211. doi: 10.6065/apem.2016.21.4.206. Epub 2016 Dec 31.

Abstract

PURPOSE

This study was to evaluate the effect of neonatal, maternal, and delivery factors on neonatal thyroid-stimulating hormone (TSH) of healthy newborns.

METHODS

Medical records of 705 healthy infants born through normal vaginal delivery were reviewed. Neonatal TSH levels obtained by neonatal screening tests were analyzed in relation to perinatal factors and any associations with free thyroxine (FT4) and 17-α hydroxyprogesterone (17OHP) levels.

RESULTS

An inverse relationship was found between TSH and sampling time after birth. Twin babies and neonates born by vacuum-assisted delivery had higher TSH levels than controls. First babies had higher TSH levels than subsequent babies. Birth weight, gestational age, maternal age and duration from the rupture of the membrane to birth were not related to neonatal TSH. There were no significant differences in TSH level according to sex, Apgar scores, labor induction, the presence of maternal disease and maternal medications. There was a positive association between TSH and 17OHP level but not between TSH and FT4 level. Multiple linear regression analyses showed that sampling time, mode of delivery, birth order, and 17OHP level were significant factors affecting neonatal TSH level.

CONCLUSION

Neonatal TSH levels of healthy normal newborns are related with multiple factors. Acute stress during delivery may influence the neonatal TSH level in early neonatal period.

摘要

目的

本研究旨在评估新生儿、母亲及分娩因素对健康新生儿甲状腺刺激激素(TSH)的影响。

方法

回顾了705例经正常阴道分娩的健康婴儿的病历。分析通过新生儿筛查测试获得的新生儿TSH水平与围产期因素的关系,以及与游离甲状腺素(FT4)和17-α羟孕酮(17OHP)水平的任何关联。

结果

发现TSH与出生后采样时间呈负相关。双胞胎和通过真空辅助分娩出生的新生儿TSH水平高于对照组。头胎婴儿的TSH水平高于后续出生的婴儿。出生体重、胎龄、母亲年龄以及胎膜破裂至出生的时长与新生儿TSH无关。根据性别、阿氏评分、引产、母亲疾病的存在及母亲用药情况,TSH水平无显著差异。TSH与17OHP水平呈正相关,但与FT4水平无关。多元线性回归分析表明,采样时间、分娩方式、出生顺序和17OHP水平是影响新生儿TSH水平的重要因素。

结论

健康正常新生儿的新生儿TSH水平与多种因素相关。分娩期间的急性应激可能会影响新生儿早期的TSH水平。

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