摘要
目的分析北京市海淀区新生儿先天性甲状腺功能减退症(congenital hypothyroidism,CH)的影响因素,为提供预防措施、降低新生儿CH发生率提供依据。方法回顾性选择2013年10月—2017年9月在北京市海淀区助产机构出生且经北京市新生儿遗传代谢病筛查程序确诊为CH的新生儿为研究对象,采用病例对照研究的方法,每个CH患儿匹配3个同一医院出生、出生日期相差不超过7 d的新生儿为对照组,共纳入CH组115例,对照组345例。从各出生医院病案系统中回顾性收集母亲孕期及新生儿信息。采用单因素及多因素logistic回归方法分析新生儿CH的可能影响因素。结果单因素分析结果显示,CH组新生儿母亲本次孕期先兆流产、妊娠期高血压疾病、妊娠期甲状腺疾病的发生率高于对照组;且早产、低出生体重和巨大儿的发生率也高于对照组,差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示,母亲患有妊娠期高血压疾病(OR=8.569,95%CI:2.448~29.992)、妊娠合并甲状腺功能亢进(OR=15.150,95%CI:1.447~158.647)、妊娠合并甲状腺功能减退(OR=2.175,95%CI:1.035~4.569)、早产(OR=5.437,95%CI:1.722~17.164)是新生儿CH的危险因素。结论新生儿CH与母亲妊娠期高血压疾病、妊娠合并甲状腺疾病及分娩孕周可能有一定关系,应加强妊娠期保健管理,降低高危因素发生的可能性,以减少新生儿CH的发生。
Objective To analyze the factors associated with neonatal congenital hypothyroidism(CH)in Haidian District,Beijing so as to provide evidence for preventive measures and reducing the rate of neonatal CH.Methods A total of 115 neonates born from October 2013 to September 2017 and diagnosed as CH by the Beijing neonatal genetic metabolic disease screening program in Haidian District were recruited as research subjects retrospectively.Each CH child was matched with three healthy neonates(born in the same hospital,birth date±7 days)by case-control study method.Therefore,there were 115 in the case group and 345 in the control group.Information of mother and her newborn were collected from hospital medical record system.Univariate and multivariate logistic regression analysis were used to analyze the factors associated with neonatal CH.Results Univariate analysis showed that the incidence of threatened abortion,hypertensive disorder complicating pregnancy and thyroid disease during pregnancy in the CH group were higher than those in the control group,and the incidence of premature delivery,low birth weight and macrosomia were higher than those in the control group(P<0.05).Logistic regression analysis showed that gestational hypertension(OR=8.569,95%CI:2.448-29.992),pregnancy with hyperthyroidism(OR=15.15,95%CI:1.447-158.647),pregnancy with hypothyroidism(OR=2.175,95%CI:1.035-4.569)and preterm birth(OR=5.437,95%CI:1.722-17.164)were risk factors for neonatal CH.Conclusion Maternal hypertension disease during pregnancy,pregnancy with thyroid disease and gestational week is associated with neonatal CH.Strengthening peri-pregnancy health care to reduce high-risk factors may help to decrease the occurrence of neonatal CH.
作者
高素红
韩萍
袁全莲
董玲
温璐
GAO Su Hong;HAN Ping;YUAN Quan Lian;DONG Ling;WEN Lu(Beijing Haidian District Maternal and Child Health Care Hospital,Beijing 100089,China)
出处
《中国妇幼卫生杂志》
2023年第2期23-26,共4页
Chinese Journal of Women and Children Health
基金
2018年度北京市优秀人才培养资助青年骨干个人项目(2018000057592G427)。
