新生儿先天性甲状腺功能低下症与出生体重及胎龄的相关性分析

目的探讨新生儿先天性甲状腺功能低下症与出生体重及胎龄的关系。方法用时间分辨荧光免疫分析法测定2010年1月~2015年7月佛山市(顺德区除外)各产科医院新生儿干血片促甲状腺激素(TSH)值,凡TSH>10.0 m IU/L者予以召回,进行甲状腺功能检查。分别按照出生体重和胎龄进行分组,并对出生体重、胎龄与TSH初筛阳性率及发病率进行相关性分析。结果共筛查标本466 078例,统计有效信息456 094例。确诊先天性甲状腺功能低下症236例,总患病率为1/1 975。其中,低出生体重儿发病率为1/744,正常出生体重儿发病率为1/2 218,巨大儿发病率为1/1 535(χ2=153.45,P=0.004)。早产儿发病率为1/975,足月儿患病率为1/1903,过期产儿患病率为1/5666(χ2=169.63,P=0.003)。不同出生体重和胎龄的患病率差异有统计学意义(P<0.05)。结论新生儿先天性甲状腺功能低下症的发病与新生儿出生时的体重、胎龄等因素有关,早产、低出生体重的新生儿甲状腺功能低下症的患病率最高。因此,加强孕期保健和管理、防止早产和减少低出生体重的发生是降低新生儿先天性甲状腺功能低下症患病率的关键。

The relationship between neonatal congenital hypothyroidism and birth weight and gestational age

Objective To investigate the relationship between neonatal congenital hypothyroidism and birth weight, and the relationship between neonatal congenital hypothyroidism and gestational age. Methods The screening of congenital hypothyroidism was conducted in all the newborns between January 2010 and July 2015 of Foshan city (except Shunde district).The thyroid stimulating hormone (TSH) was measured by time-resolved fluorescence immunoassay. If TSH > 10.0 mIU/L,then thyroid function was measured too. The newborns were grouped according to birth weight and gestational age. Correlation analysis was carried out on the birth weight / gestational age and TSH screening positive rate /prevalence. Results 466,078 infants were screened totally,and the number of effective cases was 456,094. 236 cases were diagnosed as congenital hypothyroidism and the prevalence rate was 1/1,975. Among the 236 cases,the prevalence of low weight infants,normal weight infants and great infants was 1/744,1/2,218,1/1,535, respectively (χ2=153.45,P=0.004). Among the 236 cases ,the prevalence of premature infants,term infants and expired infants was 1/975,1/1,903,1/5,666,respectively (χ2=169.63,P=0.003). Conclusion The prevalence of congenital hypothyroidism is associated with the birth weight and gestational age. Premature infants and low birth weight infants have a higher prevalence of congenital hypothyroidism. Therefore,for preventing congenital hypothyroidism , it's very important to reduce the prevalence of premature infants and low birth weight infants.