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刘田田,孙　敏,周晶敏,等.妊娠合并甲状腺功能减退症对后代出生结局及早期神经行为发育的影响[J].同济大学学报（医学版）,2021,42(6):814-818. [点击复制]
LIU Tian-tian,SUN Min,ZHOU Jing-min,et al.Impact of hypothyroidism in pregnancy on infant birth outcomes and early neurobehavioral development[J].同济大学学报（医学版）,2021,42(6):814-818. [点击复制]

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妊娠合并甲状腺功能减退症对后代出生结局及早期神经行为发育的影响
刘田田,孙　敏,周晶敏,陆　婕,陈霜慧,刘　芳
0 字体:加大+\|默认\|缩小-
(同济大学附属东方医院儿科，上海　200123)

摘要:

目的　探讨妊娠前半期合并甲状腺功能减退症妇女对其后代出生结局及早期神经行为发育的影响。方法　收集2018年1月至2020年6月于同济大学附属东方医院孕期20周内确诊并分娩的妊娠合并甲状腺功能减退症患者400例作为观察组，选取正常妊娠孕产妇400例作为对照组，比较两组后代出生结局；从中选择于我院儿童保健门诊建档随访的母亲妊娠合并甲状腺功能减退的婴幼儿105例作为观察组，同期母亲正常妊娠的婴幼儿105例作为对照组，比较两组出生后42 d及6月龄体格生长发育情况，采用格塞尔发育量表评估两组6月龄时早期神经行为发育情况。结果　观察组早产30例（750%）、低出生体质量25例（625%），对照组早产15例（375%）、低出生体质量11例（275%），观察组出生结局不良率明显高于对照组（P＜005）。观察组42 d龄体质量及身长显著低于对照组，6月龄身长显著低于对照组；6月龄时观察组大运动发育商、语言发育商得分低于对照组，两组比较有差异有统计学意义（P＜005）。结论　妊娠合并甲状腺功能减退症对后代出生结局以及婴幼儿早期体格生长和神经行为发育存在一定的不良影响，应该加强妊娠期甲状腺功能的监测并且及时干预。

关键词: 甲状腺功能减退症出生结局神经行为发育

DOI：10.12289/j.issn.1008-0932.21272

基金项目:上海市浦东新区卫生系统重要薄弱学科建设基金(PWZbr2017-23)

Impact of hypothyroidism in pregnancy on infant birth outcomes and early neurobehavioral development

LIU Tian-tian,SUN Min,ZHOU Jing-min,LU Jie,CHEN Shuang-hui,LIU Fang

(Dep. of Pediatrics, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai 200123, China)

Abstract:

Objective　To investigate the impact of hypothyroidism in early half pregnancy on infant birth outcomes and early neurodevelopment. Methods　Clinical records of 400 pregnant women with hypothyroidism delivered in East Hospital Tongji University from January 2018 to January 2020 were retrospectively reviewed（observation group). The neonatal outcomes were compared with those of 400 healthy pregnant women who delivered during the same period（control group). The physical growth of offsprings（105 cases in each group) was assessed at 42 d and at 6 month after birth, and neurobehavioral development was assessed at 6 month after birth with Gesell developmental scale. Results　The premature birth rate in study group was higher than that of control group[30(750%) vs. 15(375%), P<005]. The low birth weight rate in study group was higher than that of control group[25(625%) vs. 11(270%), P<005]. The body weight and highs at 42 d， and the body length at 6 months of the study group were significantly lower than those of the control group. The GMQ and LQ of Gesell developmental scale at 6 month of age were significantly lower in the study group than those in control group（P＜005). Conclusion　Hypothyroidism in pregnant women may impact neonatal outcomes, physical growth and neurobehavioral development of offspring. Monitoring of thyroid function and timely intervention should be considered during pregnancy.

Key words: hypothyroidism birth outcomes neurobehavioral development