测定GD妊娠妇女TRAb对子代的风险评估

Assessment of the Risk of Developing Hyperthyroidism in Neonates of Pregnant Women with Graves' Disease Through Determination of Maternal Serum Levels of TRAb

目的:探讨妊娠母体患毒症型弥漫性甲状腺肿(Graves’病,GD)对新生儿及儿童期甲状腺功能的影响。方法:采用放射免疫分析(RIA)测定近几年本院及妇幼保健院妊娠妇女258例及其新生儿259例甲状腺功能及血清促甲状腺素受体抗体(TRAb)含量。观察子代甲状腺机能状况。结果:孕妇甲亢可以直接影响胎儿宫内生长发育,引起宫内发育迟缓,新生儿甲亢与母体甲状腺激素水平相关。结论:对患甲亢的孕妇,不论其临床症状控制得是否满意,均应查TRAb,如果增高则应密切观察新生儿临床表现,定期复查甲状腺功能,及时发现功能异常,以免影响儿童生长发育。

Objective To study the risk of developing hyperthyroidism in neonates of women with Graves＇s disease through determination of maternal serum levels of TRAb.Methods Serum TRAb TSH levels were measured with CLIA and thyroid hormones levels were measured with RIA in 258 pregnant women with Graves＇ disease（98 week during gstation period）and their neonates（n=259,with a case of twin-baby）（umbilical blood specimen and neonates＇ venous specimen）as well as once in 30 normal pregnant women as controls.Results Of the 258 pregnant women,serum TRAb levels were normal（bolow 1.75IU/L）in 146 women and the neonates＇ serum TRAb levels were also normal.Serum TRAb levels were between 1.75~8.75IU/L in 109 women and the neonates＇ serum TRAb levels were somewhat increased but became normal within 15 days.Only three pregnant women had serum TRAb levels above 8.75IU/L and two of their neonates were frankly hyperthyroid,requiring ATD treatment.Conclusion Monitoring serum TRAb levels in pregnant women with history of Graves＇ disease is desirable.Neonates from those with high serum TRAb levels should be examined carefully for possible development of hyperthyroidism.