Zhonghua Er Ke Za Zhi. 2022 Jun 2;60(6):545-550. doi: 10.3760/cma.j.cn112140-20211219-01054.
To investigate the incidence and perinatal risk factors of congenital hypothyroidism (CH) in very preterm infants. This prospective, multicenter observational cohort study was conducted at 33 neonatal intensive care units based on the data from Sina-northern Neonatal Network (SNN). Perinatal information and thyroid function of 3 179 very preterm infants with gestational age <32 weeks who were born from January 2019 to June 2021 was collected. According to the occurrence of CH during hospitalization, all the infants were assigned into CH group and non-CH group. Chi square test, Fisher exact probability method, rank sum test and multivariate Logistic regression model were tested to detect the perinatal risk factors for CH. A total of 3 179 very preterm infants were enrolled with 56.4% (1 793/3 179) male. The incidence of CH was 6.9% (220/3 179), in which the incidence for extremely low birth weight infant (ELBWI) and extremely preterm infants (EPI) of gestational age <28 weeks were 13.5% (64/475) and 13.9% (66/475), respectively. On Logistic regression analysis, maternal hypertensive disorders of pregnancy (=1.59, 95% 1.14-2.23, =0.007) and multiple birth (=1.60, 95% 1.18-2.17, =0.003) were both significant perinatal risk factors of CH. In addition, gestational age (=0.81, 95% 0.71-0.93, =0.002), birth weight (=0.99, 95%: 0.98-0.99, <0.001) and 1 min Apgar score (=0.92, 95% 0.86-0.98, =0.008) were protective factors. The incidence of CH is high in very preterm infants which increased with the decreased birth weight and gestational age. For very premature infants with perinatal high risk factors such as hypertensive disorders of pregnancy, attention should be paid to assess thyroid function status dynamically.
调查极早产儿先天性甲状腺功能减退症（CH）的发病率及围产期危险因素。本前瞻性、多中心观察性队列研究基于新浪北方新生儿网络（SNN）的数据，在33个新生儿重症监护病房开展。收集了2019年1月至2021年6月出生的3179例孕周<32周的极早产儿的围产期信息和甲状腺功能。根据住院期间CH的发生情况，将所有婴儿分为CH组和非CH组。采用卡方检验、Fisher确切概率法、秩和检验和多因素Logistic回归模型检测CH的围产期危险因素。共纳入3179例极早产儿，其中男性占56.4%（1793/3179）。CH的发病率为6.9%（220/3179），其中出生体重极低的婴儿（ELBWI）和孕周<28周的极早产儿（EPI）的发病率分别为13.5%（64/475）和13.9%（66/475）。多因素Logistic回归分析显示，母亲妊娠期高血压疾病（=1.59，95%可信区间1.14 - 2.23，=0.007）和多胎妊娠（=1.60，95%可信区间1.18 - 2.17，=0.003）均为CH的重要围产期危险因素。此外，孕周（=0.81，95%可信区间0.71 - 0.93，=0.002）、出生体重（=0.99，95%可信区间：0.98 - 0.99，<0.001）和1分钟阿氏评分（=0.92，95%可信区间0.86 - 0.98，=0.008）为保护因素。极早产儿CH的发病率较高，且随出生体重和孕周的降低而增加。对于有妊娠期高血压疾病等围产期高危因素的极早产儿，应注意动态评估甲状腺功能状态。
