Foshan Institute of Fetal Medicine, Affiliated Foshan Maternity and Child Healthcare Hospital, Southern Medical University, Foshan, China.
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Front Endocrinol (Lausanne). 2021 Feb 5;11:611071. doi: 10.3389/fendo.2020.611071. eCollection 2020.
Although research suggests a close association between maternal thyroid function and birth outcomes, no clear conclusion has been reached. We aimed to explore this potential association in a retrospective cohort study.
This study included 8985 mother-child dyads. The maternal serum free tetraiodothyronine (FT4), thyroid-stimulating hormone (TSH), and thyroid peroxidase antibody (TPO Ab) concentrations and birth outcome data were reviewed from medical records. Subjects with TPO Ab concentrations of >34 and ≤34 IU/ml were classified into the TPO Ab positivity (+) and TPO Ab negativity (-) groups, respectively.
Compared with subjects in the normal group (0.1 ≤ TSH < 2.5 mIU/L and TPO Ab-), those with TSH concentrations of 2.5-4.0 mIU/L and TPO Ab- had a 0.65-fold lower risk of low birth weight (LBW). In contrast, those with TSH concentrations of >4.0 mIU/L, regardless of the TPO Ab status, had a 2.01-fold increased risk of LBW. Subclinical hypothyroidism, regardless of the TPO Ab status, was associated with a 1.94-fold higher risk of LBW when compared with that in subjects with euthyroidism and TPO Ab-. No other significant associations were observed.
A maternal TSH concentration of 2.5-4.0 mIU/L was associated with a lower risk of LBW when combined with TPO Ab-, whereas subjects with a TSH concentration of >4.0 mIU/L had an increased risk of LBW. Subclinical hypothyroidism appears to be associated with a higher risk of LBW.
尽管研究表明母体甲状腺功能与出生结局密切相关，但尚未得出明确结论。本研究旨在通过回顾性队列研究探讨这种潜在关联。
本研究纳入了 8985 对母婴对子。从病历中回顾了母体血清游离四碘甲状腺原氨酸（FT4）、促甲状腺激素（TSH）和甲状腺过氧化物酶抗体（TPO Ab）浓度以及出生结局数据。将 TPO Ab 浓度>34 和≤34 IU/ml 的受试者分别分为 TPO Ab 阳性（+）和 TPO Ab 阴性（-）组。
与正常组（0.1≤TSH<2.5 mIU/L 且 TPO Ab-）相比，TSH 浓度为 2.5-4.0 mIU/L 且 TPO Ab-的受试者发生低出生体重（LBW）的风险降低了 0.65 倍。相比之下，无论 TPO Ab 状态如何，TSH 浓度>4.0 mIU/L 的受试者发生 LBW 的风险增加了 2.01 倍。与甲状腺功能正常且 TPO Ab-的受试者相比，无论 TPO Ab 状态如何，亚临床甲状腺功能减退症发生 LBW 的风险增加了 1.94 倍。未观察到其他显著关联。
当 TPO Ab-时，TSH 浓度为 2.5-4.0 mIU/L 与 LBW 风险降低相关，而 TSH 浓度>4.0 mIU/L 时 LBW 风险增加。亚临床甲状腺功能减退症似乎与 LBW 风险增加相关。
