Koga Y, Sano H, Kikukawa Y, Ishigouoka T, Kawamura M
Department of Pediatrics, Nikko Memorial Hospital, Muroran, Japan.
J Obstet Gynaecol (Tokyo 1995). 1995 Dec;21(6):581-5. doi: 10.1111/j.1447-0756.1995.tb00916.x.
Our objective was to evaluate the effect on the neonatal thyroid function of povidone-iodine (PVP-I) used on mothers during the perinatal period.
Eight consecutive-term pregnant women were randomly separated into 4 groups. Either PVP-1 or benzethonium chloride (BC) was used to disinfect both maternal skin during labor and vaginal lacerations after delivery in Group I and IV; and PVP-1 or BC was supplied to either skin or lacerations in Groups II and III. On day 5, we measured the iodide concentration in breast milk and random urine of neonates, and the levels of neonatal thyroid-stimulating hormone (TSH) and free thyroxine.
The TSH levels in Group I and the breast-milk iodide concentrations in Groups I and II were significantly higher than those in Group IV (p < 0.05). Dietary iodide intake from breast milk correlated significantly with urinary iodide concentrations (r = 0.52, p < 0.001). In our clinic, the recall rate at the time of screening for congenital hypothyroidism was significantly decreased by discontinuing the use of PVP-I (4.47% vs 0.74%, p < 0.001).
These findings suggest that the use of PVP-I on mothers is associated with transient neonatal hyperthyrotropinemia, in which breast milk might play an important role. Therefore, we recommend that the use of PVP-I be avoided during labor.
我们的目的是评估围产期母亲使用聚维酮碘（PVP-I）对新生儿甲状腺功能的影响。
连续8名足月孕妇被随机分为4组。在第一组和第四组中，使用PVP-1或苄索氯铵（BC）对产妇分娩时的皮肤和产后的阴道撕裂伤进行消毒；在第二组和第三组中，PVP-1或BC分别用于皮肤或撕裂伤。在第5天，我们测量了新生儿母乳和随机尿液中的碘化物浓度，以及新生儿促甲状腺激素（TSH）和游离甲状腺素的水平。
第一组的TSH水平以及第一组和第二组的母乳碘化物浓度显著高于第四组（p<0.05）。母乳中的膳食碘摄入量与尿碘浓度显著相关（r = 0.52，p<0.001）。在我们的诊所，通过停止使用PVP-I，先天性甲状腺功能减退症筛查时的召回率显著降低（4.47%对0.74%，p<0.001）。
这些发现表明，母亲使用PVP-I与短暂性新生儿促甲状腺激素血症有关，其中母乳可能起重要作用。因此，我们建议在分娩期间避免使用PVP-I。
