宁波市江北区孕妇碘营养状况与新生儿甲状腺功能分析

Investigation on iodine nutrition of pregnant women and thyroid function of newborn in Jiangbei District of Ningbo City

目的调查和评估江北区孕妇碘营养状况和新生儿甲状腺功能情况,为科学补碘防控策略提供依据。方法以2014年3—10月江北区3个调查点（分别代表城区、城乡结合部、农村）161名孕妇为调查对象,采集孕妇尿样检测尿碘含量,比较分析不同地理区域、不同孕期孕妇碘营养状况。采集孕妇静脉血及配对新生儿脐带血测定血清中游离三碘甲状腺原氨酸（FT3）、游离甲状素（FT4）及促甲状腺素（TSH）,并分析两者间关系。结果 161名孕妇尿碘水平的中位数为178.67μg/L。其中,碘过量者（尿碘〉500μg/L）占3.73%（6/161）,碘足量者（尿碘250-499μg/L）占33.54%（54/161）,碘适量者（尿碘150-249μg/L）占22.36%（36/161）,碘缺乏者（尿碘〈150μg/L）占40.37%（65/161）。江北区城区、城乡结合部、农村3个不同地理区域孕妇尿碘水平有一定差异,农村高于城区。孕晚期孕妇尿碘中位数为159.06μg/L。36名新生儿血清中FT3、FT4水平分别为（2.60±0.35）、（13.81±1.63）pmol/L,血清TSH水平的平均数为3.38 m IU/L。孕妇尿碘水平与新生儿血清FT3和TSH水平无关（P〉0.05）,但与FT4水平有关（P〈0.01）。结论江北区大部分孕妇碘营养状况处于适宜水平,但仍有部分孕妇存在碘缺乏,孕晚期孕妇尿碘含量偏低,配对孕妇与新生儿FT4水平呈正相关。应加强孕妇碘营养状况及新生儿甲状腺功能监测。

Objective To investigate and evaluate the iodine nutritional status of pregnant women and thyroid function of new born children in Jiangbei District,and provide the basis for rational iodine supplement. Methods From March 2014 to October 2014,three survey spots（ representing the city,the rural-urban continum,and the countryside） investigated a total of 161 pregnant women,whose urine were tested for urine iodine. Comparative analysis was done on iodine nutritional status in different geographical areas and different pregnancy. Blood of pregnant women and matching neonatal umbilical cord blood were tested for free triiodothyronine（ FT3） and free thyroxine（ FT4） and thyroid-stimulating hormone（ TSH）,with analysis on the relationship between the two. Results Median of the 161 pregnant women urine iodine level was 178. 67 μg / L. Among them,the iodine excess（ urine iodine,〉 500 mu g / L） accounted for3. 73%（ 6 /161）,iodine sufficiency（ urinary iodine 250 ~ 499 μg / L） 33. 54%（ 54 /161）,iodine moderacy（ urinary iodine 150 ~ 249 μg /L） 22. 36%（ 36 /161）,iodine deficiency（ urinary iodine 〈 150 μg /L）40. 37%（ 65 /161）. Urine iodine levels in pregnant women from three different geographical areas showed no statistical difference. Median urine iodine of pregnant women in third trimester was 148. 23 μg / L. FT3,FT4 level of 36 neonatal was（ 2. 60 ± 0. 35） and（ 13. 81 ± 1. 63） pmol / L respectively,the average serum TSH level was 3. 38 m IU / L. Pregnant women urine iodine level paired with FT3,TSH level of neonatal serum showed no correlation（ P 〉 0. 05）,but were positively correlated in FT4level（ P 〈 0. 01）. Conclusion Iodine nutritional status in most pregnant women in Jiangbei District is at appropriate levels,but there is still some iodine deficiency found in them. Urine iodine content of pregnant women in third trimester was low; FT4 levels were positively correlated in matched pregnant woman and newborn. In view of this situation,monitoring of the iodine nutritional status in pregnant women and neonatal thyroid function should be enhanced.