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通过检测新生儿脐血促甲状腺激素(CBTSH)水平筛查先天性甲状腺功能减退症。

Screening for congenital hypothyroidism by using cord blood thyroid stimulating hormone (CBTSH) levels in neonates.

作者信息

Gudaganatti Laxmi, Sajjan Sangamma G, Khursheed Romana

机构信息

Department of Biochemistry, KAHER, J.N. Medical College, Belagavi, Karnataka, India.

Department of OBST and Gynaecology, KAHER, J.N. Medical College, Belagavi, Karnataka, India.

出版信息

J Family Med Prim Care. 2025 Apr;14(4):1375-1378. doi: 10.4103/jfmpc.jfmpc_1393_24. Epub 2025 Apr 25.

Abstract

BACKGROUND

Congenital hypothyroidism (CH) is the most common preventable cause of mental retardation in children. Hypothyroidism in the neonatal period is always overlooked, and delayed discovery results in the most devastating outcomes, such as mental retardation, stressing the importance of newborn screening, which is one of the major achievements in preventive medicine. According to previous studies, Thyroid-Stimulating Hormone (TSH) screening is more specific for identifying CH. TSH levels in umbilical cord blood remain an easy and useful means to screen for congenital hypothyroidism, and it is widely documented that maternal and neonatal factors influence Cord Blood Thyroid Stimulating Hormone (CBTSH) levels. The current study was conducted to screen for and determine the effects of various perinatal and maternal variables on CBTSH levels.

OBJECTIVES

To evaluate the incidence of congenital hypothyroidism using CBTSH) levels and to examine the influence of maternal and perinatal factors on these levels.

MATERIAL AND METHODS

This cross-sectional study included 106 neonates. Samples were collected from the neonatal ward of a tertiary care hospital in urban south Karnataka, India. An umbilical cord blood sample was collected, and the CBTSH assay was performed using the electrochemiluminescence method. The data obtained were statistically analyzed.

RESULT

In the present study, the mean cord blood TSH level was 6.20 ± 5.90 μIU/ml. There was a statistically significant association between the mean CBTSH level and maternal complications (Age, mode of delivery, gravida, and prenatal hypothyroidism status). A higher CBTSH level was found in preterm babies with an APGAR score of <7, vaginal deliveries, primigravida, male sex, and low-birth-weight babies.

CONCLUSION

This study found a significant association between CBTSH levels and maternal health problems. Preterm newborns with an appearance, pulse, grimace, activity, and respiration score of <7, normal vaginal delivery, primigravida, male sex, and low birth weight had higher CBTSH levels.

摘要

背景

先天性甲状腺功能减退症(CH)是儿童智力发育迟缓最常见的可预防病因。新生儿期甲状腺功能减退症常被忽视,发现延迟会导致最严重的后果,如智力发育迟缓,这凸显了新生儿筛查的重要性,新生儿筛查是预防医学的主要成就之一。根据以往研究,促甲状腺激素(TSH)筛查对识别CH更具特异性。脐血中的TSH水平仍然是筛查先天性甲状腺功能减退症的一种简便且有用的方法,并且有大量文献记载,母体和新生儿因素会影响脐血促甲状腺激素(CBTSH)水平。本研究旨在筛查并确定各种围产期和母体变量对CBTSH水平的影响。

目的

使用CBTSH水平评估先天性甲状腺功能减退症的发病率,并研究母体和围产期因素对这些水平的影响。

材料与方法

这项横断面研究纳入了106名新生儿。样本取自印度卡纳塔克邦南部城市一家三级护理医院的新生儿病房。采集脐血样本,并采用电化学发光法进行CBTSH检测。对获得的数据进行统计学分析。

结果

在本研究中,脐血TSH平均水平为6.20±5.90μIU/ml。平均CBTSH水平与母体并发症(年龄、分娩方式、妊娠次数和产前甲状腺功能减退状态)之间存在统计学显著关联。在Apgar评分<7的早产儿、阴道分娩儿、初产妇、男性以及低体重儿中发现CBTSH水平较高。

结论

本研究发现CBTSH水平与母体健康问题之间存在显著关联。外观、脉搏、面部表情、活动和呼吸评分<7的早产新生儿、正常阴道分娩、初产妇、男性以及低体重儿的CBTSH水平较高。

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本文引用的文献

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Effect of maternal and neonatal factors on cord blood thyroid stimulating hormone.
Indian J Endocrinol Metab. 2016 May-Jun;20(3):317-23. doi: 10.4103/2230-8210.179998.

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