Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Endocrinology Unit, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Am J Perinatol. 2019 Jul;36(9):975-980. doi: 10.1055/s-0038-1675834. Epub 2018 Nov 26.
Previous studies suggested maternal hypothyroidism during pregnancy to be associated with cognitive impairment of the offspring. Scarce data exist regarding long-term endocrine health of the offspring. This study was aimed to assess whether children born to mothers with hypothyroidism during pregnancy are at an increased risk for long-term endocrine morbidity.
A retrospective population-based cohort study compared long-term endocrine morbidity of children born between the years 1991 and 2014 to mothers with and without hypothyroidism. Multiple gestations, fetuses with congenital malformations, and women lacking prenatal care were excluded. Hospitalizations of the offspring up to the age of 18 years involving endocrine morbidity were evaluated according to a predefined set of ICD-9 codes. Kaplan-Meier's survival curves were used to compare the cumulative risk and a Cox multivariable model was used to adjust for confounders.
During the study period, 217,910 deliveries met the inclusion criteria; 1.1% of which were with maternal hypothyroidism ( = 2,403). During the follow-up period, the cumulative incidence of endocrine morbidity among children born to mothers with hypothyroidism was 27 per 1,000 person-years and 0.47 per 1,000 person-years in the comparison group (relative risk: 2.14; 95% confidence interval [CI]: 1.21-3.79). The Kaplan-Meier's survival curve demonstrated a significantly higher cumulative endocrine morbidity in children born to mothers with hypothyroidism (log-rank test, = 0.007). In the Cox regression model controlled for maternal age, birth weight, preterm birth, maternal diabetes, hypertensive disorders of pregnancy, induction of labor, and mode of delivery, maternal hypothyroidism was found to be independently associated with pediatric endocrine morbidity in the offspring (adjusted hazard ratio = 1.92, 95% CI: 1.08-3.4, = 0.025).
Maternal hypothyroidism appears to be independently associated with long-term pediatric endocrine morbidity of the offspring.
先前的研究表明，母亲在怀孕期间患甲状腺功能减退症与后代的认知障碍有关。关于后代的长期内分泌健康，相关数据很少。本研究旨在评估患有甲状腺功能减退症的母亲所生的孩子是否存在长期内分泌疾病的风险增加。
这是一项回顾性基于人群的队列研究，比较了 1991 年至 2014 年间患有和不患有甲状腺功能减退症的母亲所生子女的长期内分泌疾病发病率。排除多胎妊娠、胎儿先天性畸形和缺乏产前保健的女性。根据预先设定的 ICD-9 编码，评估了 18 岁以下子女住院的内分泌疾病情况。使用 Kaplan-Meier 生存曲线比较累积风险，并使用 Cox 多变量模型调整混杂因素。
在研究期间，有 217910 次分娩符合纳入标准，其中 1.1%的母亲患有甲状腺功能减退症（ = 2403）。在随访期间，患有甲状腺功能减退症的母亲所生子女的内分泌疾病累积发病率为每 1000 人年 27 例，而对照组为每 1000 人年 0.47 例（相对风险：2.14；95%置信区间 [CI]：1.21-3.79）。Kaplan-Meier 生存曲线显示，患有甲状腺功能减退症的母亲所生子女的内分泌疾病累积发病率显著更高（对数秩检验， = 0.007）。在调整了母亲年龄、出生体重、早产、母亲糖尿病、妊娠高血压疾病、引产和分娩方式的 Cox 回归模型中，母亲甲状腺功能减退症与后代的儿科内分泌疾病独立相关（调整后的危险比 = 1.92，95% CI：1.08-3.4， = 0.025）。
母亲甲状腺功能减退症似乎与后代的长期儿科内分泌疾病独立相关。
