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维生素A对孕早期母体甲状腺激素与胎儿生长关系的影响:一项前瞻性队列研究。

Effect of vitamin A on the relationship between maternal thyroid hormones in early pregnancy and fetal growth: A prospective cohort study.

作者信息

Lyu Yanyu, Xiu Qingyong, Zuo Hanxiao, Xu Guangfei, Cui Xiaodai, Sun Zhenfeng, Mi Rong, Wu Lijun

机构信息

Experiment Center, Capital Institute of Pediatrics, Beijing, China.

Department of Pediatrics, Beijing Daxing Maternal and Child Care Hospital, Beijing, China.

出版信息

Front Nutr. 2022 Aug 24;9:980853. doi: 10.3389/fnut.2022.980853. eCollection 2022.

Abstract

BACKGROUND

Fetal growth patterns are influenced by maternal thyroid function and vitamin A level during pregnancy. Vitamin A presents interactions with thyroid tissues and hormonal systems. We examined whether vitamin A status modified the associations of maternal thyroid hormones in early pregnancy and fetal growth outcomes among euthyroid pregnant women in a prospective cohort study ( = 637).

METHODS

We performed multiple linear regression and multinomial logistic regression analysis to investigate the effects of thyroid hormones in early pregnancy on fetal growth according to different levels of serum vitamin A based on median value.

RESULTS

A 1 pmol/L increase in maternal free triiodothyronine (FT3) levels was associated with an increased birth weight of 0.080 kg ( = 0.023) in women with lower maternal vitamin A levels in early pregnancy. Increased maternal free thyroxine (FT4) was associated with decreased odds for both small size for gestational age (SGA) [odds ratios (OR) = 0.66, 95% confidence interval (CI): 0.45-0.95] and large size for gestational age (LGA) (OR = 0.66, 95% CI: 0.45-0.98) in women with higher vitamin A level in early pregnancy after adjustment for maternal prepregnancy body mass index, gestational weight gain, maternal employed, parity, gestational week at sampling, and gestational diabetes mellitus.

CONCLUSIONS

In Chinese pregnant women without overt thyroid dysfunction, maternal FT4 in early pregnancy was positively associated with optimal fetal growth among women with higher serum vitamin A concentrations.

摘要

背景

胎儿生长模式受孕期母亲甲状腺功能和维生素A水平影响。维生素A与甲状腺组织及激素系统存在相互作用。在一项前瞻性队列研究(n = 637)中,我们研究了维生素A状态是否改变了甲状腺功能正常的孕妇孕早期母体甲状腺激素与胎儿生长结局之间的关联。

方法

我们进行了多元线性回归和多项逻辑回归分析,以根据血清维生素A基于中位数的不同水平,研究孕早期甲状腺激素对胎儿生长的影响。

结果

在孕早期母体维生素A水平较低的女性中,母体游离三碘甲状腺原氨酸(FT3)水平每升高1 pmol/L,出生体重增加0.080 kg(P = 0.023)。在调整了母体孕前体重指数、孕期体重增加、母亲就业情况、产次、采样时的孕周和妊娠期糖尿病后,孕早期维生素A水平较高的女性中,母体游离甲状腺素(FT4)升高与小于胎龄儿(SGA)[比值比(OR)= 0.66,95%置信区间(CI):0.45 - 0.95]和大于胎龄儿(LGA)(OR = 0.66,95% CI:0.45 - 0.98)的发生几率降低相关。

结论

在中国无明显甲状腺功能障碍的孕妇中,孕早期母体FT4与血清维生素A浓度较高的女性中胎儿的最佳生长呈正相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d426/9449534/c5be0a6a35be/fnut-09-980853-g0001.jpg

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