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妊娠体重增加对母甲状腺激素与出生结局相关性的影响。

Effect of Gestational Weight Gain on Associations Between Maternal Thyroid Hormones and Birth Outcomes.

机构信息

Eugenic Genetics Laboratory, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.

Technology Department, Wuhan Pengxiang Medical Equipment Co., Ltd., Wuhan, China.

出版信息

Front Endocrinol (Lausanne). 2020 Sep 3;11:610. doi: 10.3389/fendo.2020.00610. eCollection 2020.

Abstract

The aim was to investigate the associations between maternal thyroid parameters within the normal ranges during early pregnancy and birth outcomes, and further to examine whether the associations were modified by gestational weight gain (GWG). Maternal serum thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) concentrations within the normal ranges during early pregnancy were measured from 8,107 pregnant women in Wuhan, China. The associations between maternal thyroid parameters and birth outcomes (birth weight, birth length, and low birth weight) were analyzed using multivariable adjusted regression models, and effect modification by pre-pregnancy body mass index (BMI) category and GWG were further evaluated. Maternal TSH and FT4 concentrations were negatively associated with birth weight, and the latter only occurred in normal weigh women with inadequate and excessive GWG, as well as in both underweight and overweight women with excessive GWG (e.g., β = -359.33 g, 95% CI: -700.95, -17.72 in underweight women with excessive GWG for per unit increase of FT4 concentrations). Moreover, maternal FT4 and FT3 concentrations were associated with increased risk for low birth weight, and the latter only occurred in normal weigh women with inadequate GWG (OR = 2.52, 95% CI: 1.00, 6.36 for per unit increase of FT3 concentrations). These associations still persist when maternal thyroid parameters were modeled as quintiles. Maternal normal thyroid function during early pregnancy with excessive and inadequate GWG may adversely influence fetal growth.

摘要

目的是研究孕早期甲状腺参数在正常范围内与出生结局之间的关联,并进一步探讨这些关联是否受妊娠体重增加(GWG)的影响。在中国武汉,对 8107 名孕妇的血清促甲状腺激素(TSH)、游离甲状腺素(FT4)和游离三碘甲状腺原氨酸(FT3)浓度进行了检测,这些浓度均在孕早期处于正常范围内。使用多变量调整回归模型分析了母体甲状腺参数与出生结局(出生体重、出生体长和低出生体重)之间的关联,并进一步评估了孕前体重指数(BMI)类别和 GWG 的修饰作用。母体 TSH 和 FT4 浓度与出生体重呈负相关,后者仅发生在 GWG 不足和过多的正常体重女性以及 GWG 过多的消瘦和超重女性中(例如,FT4 浓度每增加一个单位,消瘦女性 GWG 过多时出生体重降低 359.33g,95%CI:-700.95,-17.72)。此外,母体 FT4 和 FT3 浓度与低出生体重的风险增加相关,后者仅发生在 GWG 不足的正常体重女性中(FT3 浓度每增加一个单位,OR=2.52,95%CI:1.00,6.36)。当母体甲状腺参数被建模为五分位时,这些关联仍然存在。孕早期母体甲状腺功能正常但 GWG 过多或不足可能会对胎儿生长产生不利影响。

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