分娩方式对产妇及其新生儿促甲状腺激素水平影响的研究

目的探讨不同分娩方式对产妇及其新生儿促甲状腺激素(TSH)水平的影响.方法应用放射免疫分析法,检测213例产妇及其新生儿的TSH水平,按分娩方式不同分为正常分娩组140例,剖宫产组38例,产钳组35例.结果(1)产钳组产妇TSH为(4.13±0.69)mU/L,正常分娩组产妇为(2.58±0.87)mU/L,两组比较,差异有极显著性(P＜0.01).剖宫产组产妇TSH为(2.81±0.45)mU/L,同产钳组产妇比较,差异有极显著性(P＜0.01);同正常分娩组产妇比较,差异无显著性(P＞0.05).(2)产钳组新生儿TSH为(8.85±2.48)mU/L,正常分娩组新生儿为(5.36±2.23)mU/L,两组比较,差异有极显著性(P＜0.01).剖宫产组新生儿TSH为(3.84±2.16)mU/L,同正常分娩组比较,差异有显著性(P＜0.05).(3)3组产妇及其新生儿TSH水平之间呈显著正相关.结论产妇和新生儿TSH水平的高低与不同分娩方式有关.产妇TSH水平变化用于评估新生儿TSH水平具有可行性.

Study on effect of delivery way on thyrotropin levels in pregnant women and their newborns

OBJECTIVE: To investigate the effect on thyrotropin (TSH) levels of pregnant women and their newborns in different delivery ways. METHODS: The serum TSH levels of 213 pregnant women and the umbilical cord blood TSH levels of their newborns (140 cases from normal vaginal delivery, 38 cases from cesarean section, 35 cases from low forceps delivery) were tested by immunoradiometric assay. Urinary iodine was detected from pregnant women before delivery. RESULTS: In pregnant women, the mean serum level of TSH in the forceps group [(4.13 +/- 0.69) mU/L] was significantly higher than those of the normal birth group [(2.58 +/- 0.87) mU/L, P < 0.01] and the cesarean section group [(2.81 +/- 0.45) mU/L, P < 0.01]. There was no difference in TSH level between the normal birth group and the cesarean section group. In newborns, the mean TSH level in the forceps group [(8.85 +/- 2.48) mU/L] was significantly higher than those of the normal birth group [(5.36 +/- 2.23) mU/L, P < 0.01] and the cesarean section group [(3.84 +/- 2.16) mU/L, P < 0.01]. The mean TSH level in the normal birth group was significantly higher than that of the cesarean section group (P < 0.05). The serum TSH levels of pregnant women were positively correlated with the umbilical cord blood TSH levels of their newborns in three groups. CONCLUSIONS: The contraction of uterus is the stimulus for the surge in TSH levels of pregnant women and their newborns after delivery. It's reliable that the TSH levels of newborns could be evaluated by monitoring the TSH levels of pregnant woman.