新生儿先天性甲状腺功能低下症与出生体重及胎龄关系的研究

目的:探讨新生儿先天性甲状腺功能低下症(CH)与不同出生体重及胎龄的关系。方法:对浙江省2005年活产婴儿进行CH筛查。采用时间分辨荧光免疫方法,检测新生儿足跟血斑的促甲状腺素(TSH)指标。凡滤纸血TSH>9.0 mIU/L者予以召回,进行甲状腺功能等检查。结果:2005年共筛查新生儿387926人,确诊CH病例289人,CH发病率为1/1342。其中,早产儿(胎龄<37周)CH发病率为1/1454,足月儿(胎龄37~42周)为1/1469,过期产儿(胎龄>42周)为1/246;过期产儿CH发病率明显高于另外两组儿童(P<0.01)。在低出生体重儿童中,CH发病率为1/575,正常体重组儿童发病率为1/1505,而巨大儿发病率为1/473,低出生体重儿童及巨大儿的CH发病率明显高于正常体重组儿童(P<0.01)。结论:CH的发病与新生儿出生时的体重、胎龄等因素有关。过期产儿、低出生体重、巨大儿的新生儿CH的发病率最高;因此,防止过期产、减少低出生体重和巨大儿的出生、注意孕期保健是减少CH儿童的关键,这对于降低CH发病率,提高出生人口素质有着积极的意义。

Correlation of congenital hypothyroidism with birth weight and gestational age in newborn infants

Objective: To investigate the correlation of congenital hypothyroidism(CH) with birth weight and gestational age in newborn infants.Methods: The screening of CH was conducted in all the live births in 2005 of Zhejiang Province,the blood samples were collected from heel stick.The thyroid stimulating hormone(TSH) was measured by time-resolved fluorescence immunoassay(TRFIA).If TSH was>9.0 mU/L,the infant was recalled for further examination.Results: A total of 387 926 infants were screened in 2005,of whom 289 cases were identified with CH.The prevalence rate was 1/1 342.Among the 289 CH cases,the prevalence of premature infants,term infants and post term infants were 1/1 454,1/1 469 and 1/246,respectively.The CH prevalence of post term infants was significantly higher than that in other two groups(P<0.01).The prevalence of low birth weight infants,normal weight infants and macrosomia was 1/575,1/1 505 and 1/473,respectively.The prevalence of low birth weight infants and macrosomia was significantly higher than that of normal weight group(P<0.01).Conclusion: The prevalence of CH is associated with the birth weight and gestational age.To reduce the prevalence of CH in children,it is crucial to prevent post term,low birth weight,and macrosomia cases.