Fan Pianpian, Luo Zhong-Cheng, Tang Ning, Wang Weiye, Liu Zhiwei, Zhang Jun, Ouyang Fengxiu
Ministry of Education and Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Obstetrics and Gynecology, Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Front Endocrinol (Lausanne). 2020 Jan 10;10:913. doi: 10.3389/fendo.2019.00913. eCollection 2019.
Thyroid hormones are essential for fetal growth and neurodevelopment, however, data on cord blood thyroid hormones are sparse in China where maternal age at childbearing is increasing in recent decades. We aimed to assess cord blood levels of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) in full-term Chinese newborns, and examine potential related perinatal factors. This study included 922 mother-newborn pairs from a prospective birth cohort enrolled in 2012-2013, Shanghai, China. Cord serum concentrations of FT3, FT4, TSH, and TPOAb were measured in newborns. Newborns born via cesarean section had higher cord serum FT3 (mean ± SD: 1.90 ± 1.16 pmol/L) and lower cord serum TSH (5.15 ± 2.60 mIU/L) than those born via vaginal delivery (FT3: 1.62 ± 0.93 pmol/L; TSH: 9.27 ± 6.76 mIU/L). In cesarean section deliveries, the concentration of cord serum FT3 was 0.15 (95%CI: -0.03, 0.33; = 0.10) pmol/L lower in infants of mothers aged 30-34 years, and 0.57 (95%CI: 0.22, 0.92; = 0.002) pmol/L lower in infants of mothers ≥35 years compared to infants of mothers <30 years. Large-for-gestational-age (birth weight >90th percentile) was associated with higher TSH ( = 0.02). Similar results were also found in vaginal deliveries. In this Chinese term birth cohort, newborns born via cesarean section had higher cord serum FT3 and lower TSH than those born via vaginal delivery. Advanced maternal age was associated with lower fetal FT3. Further research is needed to understand whether this association may mediate the adverse impact of advanced maternal age on neurodevelopment in early life.
甲状腺激素对胎儿生长和神经发育至关重要,然而,在中国,近几十年来育龄产妇年龄不断增加,关于脐血甲状腺激素的数据却很稀少。我们旨在评估足月中国新生儿脐血中游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺激素(TSH)的水平,并研究潜在的相关围产期因素。本研究纳入了2012 - 2013年在中国上海招募的一个前瞻性出生队列中的922对母婴。测定了新生儿脐血中FT3、FT4、TSH和甲状腺过氧化物酶抗体(TPOAb)的血清浓度。剖宫产出生的新生儿脐血血清FT3水平(均值±标准差:1.90±1.16 pmol/L)高于阴道分娩的新生儿(FT3:1.62±0.93 pmol/L),脐血血清TSH水平(5.15±2.60 mIU/L)低于阴道分娩的新生儿(TSH:9.27±6.76 mIU/L)。在剖宫产分娩中,与母亲年龄小于30岁的婴儿相比,母亲年龄在30 - 34岁的婴儿脐血血清FT3浓度低0.15(95%CI: - 0.03,0.33;P = 0.10)pmol/L,母亲年龄≥35岁的婴儿脐血血清FT3浓度低0.57(95%CI:0.22,0.92;P = 0.002)pmol/L。大于胎龄儿(出生体重>第90百分位数)与较高的TSH相关(P = 0.02)。在阴道分娩中也发现了类似结果。在这个中国足月出生队列中,剖宫产出生的新生儿脐血血清FT3水平高于阴道分娩的新生儿,TSH水平低于阴道分娩的新生儿。母亲年龄较大与胎儿FT3水平较低相关。需要进一步研究以了解这种关联是否可能介导母亲年龄较大对生命早期神经发育的不利影响。