Department of Pediatrics, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Shanghai Songjiang Maternal and Child Health Care Hospital, Shanghai, China.
J Matern Fetal Neonatal Med. 2021 Jun;34(12):1897-1905. doi: 10.1080/14767058.2019.1651273. Epub 2019 Aug 9.
Previous studies suggested that thyroid function in the first trimester of gestation played an important role in fetal growth. However, limited clinical data are available to support this relationship in the second trimester of gestation.
We examined the relationship of maternal thyroid function parameters in early second trimester of gestation with birth outcomes in China.
Participating 5016 mother-infant pairs were recruited from the Songjiang District Maternity and Infant Hospital, Shanghai, China, between July and December 2016. Linear regression assessed the associations of thyroid hormones with birthweight. Logistic regression tested the correlations between thyroid hormones and low birthweight, macrosomia, small for gestational age , and large for gestational age infants. Maternal serum TSH, TT3, TT4, FT3, and FT4 concentrations were measured in 16-20 weeks of gestation.
TT3 and FT3 were positively associated with birthweight, while TT4 and FT4 were negatively associated with birthweight, respectively. Furthermore, higher TT3 and FT3 were associated with increased risks of LGA infants (OR = 1.48, 95% CI: 1.15-1.9; OR = 1.22, 95% CI: 1.01-1.46), respectively. Higher TT3 was associated with an increased risk of macrosomic infants (OR = 1.35, 95% CI: 1.04-1.74). In contrast, higher FT4 was associated with decreased risks of LGA (OR = 0.87, 95% CI: 0.81-0.93) and macrosomic infants (OR = 0.90, 95% CI: 0.84-0.96), respectively. No associations were found between TSH and any of the outcomes.
TT3 and FT3 were positively associated with fetal growth, while TT4 and FT4 were negatively associated with fetal growth. Our findings suggested that thyroid function in early second trimester of gestation is a potential risk factor for abnormal fetal growth.
先前的研究表明，妊娠早期的甲状腺功能对胎儿生长发育起着重要作用。然而，目前仅有有限的临床数据支持妊娠中期存在这种关系。
本研究旨在探讨中国妊娠中期早孕期母体内甲状腺功能参数与分娩结局的关系。
2016 年 7 月至 12 月，我们招募了 5016 对母婴，来自上海市松江区妇幼保健院。采用线性回归评估甲状腺激素与出生体重的关系。采用 logistic 回归检验甲状腺激素与低出生体重儿、巨大儿、小于胎龄儿、大于胎龄儿之间的相关性。在妊娠 16-20 周时检测了母体血清 TSH、TT3、TT4、FT3 和 FT4 浓度。
TT3 和 FT3 与出生体重呈正相关，而 TT4 和 FT4 与出生体重呈负相关。此外，较高的 TT3 和 FT3 与巨大儿（OR=1.48，95%CI：1.15-1.9；OR=1.22，95%CI：1.01-1.46）的风险增加有关。较高的 TT3 与巨大儿（OR=1.35，95%CI：1.04-1.74）的风险增加有关。相反，较高的 FT4 与 LGA（OR=0.87，95%CI：0.81-0.93）和巨大儿（OR=0.90，95%CI：0.84-0.96）的风险降低有关。TSH 与任何结局均无关联。
TT3 和 FT3 与胎儿生长呈正相关，而 TT4 和 FT4 与胎儿生长呈负相关。我们的研究结果表明，妊娠中期早孕期的甲状腺功能是异常胎儿生长的潜在危险因素。
