西安市先天性甲状腺功能减退症流行病学特征及影响因素分析

Epidemiological features and influencing factors for congenital hypothyroidism in Xi'an

目的 探讨西安市先天性甲状腺功能减退症(CH)流行病学特征及发病相关影响因素,为制订干预措施提供依据。方法 收集西安市新生儿疾病筛查中心2020年1月1日至2021年12月31日新生儿CH筛查数据,采用病例对照研究方法,对病例组及对照组患儿基础资料、临床特征等相关资料进行单因素分析,从单因素分析中筛选部分差异有统计学意义的变量,纳入多因素Logistic回归方程分析。结果 2020—2021年共筛查新生儿148 250人,确诊CH 104例。多元Logistics回归分析表明孕周长、母亲受教育程度高、出生体重较大为CH的保护因素(P<0.05),出生季节为冬季、母孕期甲状腺疾病、母亲高龄、胎次或产次多、剖宫产或阴道助产是CH的危险因素(P<0.05)。结论 西安市CH发病率与中国碘充足地区发病率基本一致,近年来西安市CH筛查率不断提高。母亲的个人因素及环境因素影响新生儿CH的发病,建议育龄期妇女做好孕前准备、孕期保健,提高人口质量。

Objective To study the epidemiological characteristics and risk factors of congenital hypothyroidism(CH)in Xi'an,and to provide evidence for making intervention strategies.Methods From January 1,2020 to December 31,2021,the screening data for neonatal CH at the Xi'an Neonatal Disease Screening Center were gathered.The case group and the control group's fundamental data,clinical characteristics,and other related data were analyzed using univariate analysis by the case-control study technique.From the univariate analysis,a few factors that were statistically different were chosen and were inclucled in the multivariate Logistic regression equation analysis.Results Between 2020 and 2021,148250 newborns were screened for CH;104 of them were found to have the disease.Multiple Logistic regression analysis revealed that long period of pregnancy,high educational level of mothers,and birth weight being 2.5~4 kg were protective factors of CH(P<0.05),while the risk factors were birth season being winter,maternal thyroid diseases during pregnancy,mother's advancedage,multiple pregnanay or delivery and cesarean section.Conclution The incidence rate of CH in Xi'an is basically the same as that in China's iodine-sufficient regions.The CH screening rate in Xi'an has steadily increased in recent years.It is advised that women of childbearing age get ready for pregnancy and receive prenatal care to improve population quality since maternal personal variables and environmental factors affect the etiology of neonatal CH.