孕妇TPO抗体和新生儿甲状腺功能关系探讨

Relationship between TPO antibodies of pregnant women and thyroid function of newborn babies

目的通过对孕妇甲状腺过氧化物酶抗体(TPOAb)和新生儿促甲状腺激素(TSH)的筛查,了解孕妇TPOAb是否会对新生儿甲状腺功能造成不良影响。方法选择230例甲状腺功能正常的妊娠早期孕妇作为研究对象,根据TPOAb结果分为阳性和阴性两组,比较两组孕妇甲状腺功能以及产后新生儿临床特征和TSH指标。结果 (1)在TPOAb阳性和阴性孕妇中,TSH水平差异有显著性(2χ=12.03,P<0.05);(2)两组新生儿临床特征差异无显著性(P>0.05);而TPOAb阳性组产妇的新生儿TSH水平高于TPOAb阴性组产妇的新生儿TSH水平,差异有显著性(t=4.681,P<0.05);(3)相关分析显示,孕妇TPOAb滴度和TSH水平分别与新生儿TSH水平呈正相关(r=0.201,0.209,均P<0.01)。结论 TPOAb阳性妊娠早期孕妇甲状腺功能有向亚临床甲状腺功能减退转化的趋势。孕妇TPOAb阳性可能会对新生儿甲状腺功能造成一定影响。

Aim To explore effects of thyroid peroxidase antibody（TPOAb） of pregnant women and neonatal thyroid function,based on screening of pregnant women TPOAb and neonatal thyroid stimulating hormone（TSH）.Methods In this study,we chose TPOAb positive and negative euthyroid pregnant women 230 cases as subjects,then compared thyroid function changes during pregnancy.We also compared neonatal clinical characteristics and neonatal TSH levels.Results In TPOAb positive and negative pregnant women,the difference of TSH levels was significant（χ2= 12.03,P0.05）.Neonatal clinical characteristics of two groups showed no significant difference（P0.05）.In the group of TPOAb positive neonatal TSH levels were higher than neonatal TSH levels of maternal TPOAb negative groups,which was significantly different（t=4.681,P0.05）.Correlation analysis showed maternal antibody titers TPOAb and TSH levels and neonatal TSH levels were positively correlated（r= 0.201,0.209,both P0.01）.Conclusion TPOAb positive pregnant women have the trend to develop subclinical hypothyroidism,and TPOAb positive maybe have some effect on neonatal thyroid function.