孕妇亚临床甲状腺功能减退对婴幼儿神经心理发育的影响

Effect of maternal subclinical hypothyroidism on neuropsychological development of infants

目的探究孕妇亚临床甲状腺功能减退对婴幼儿神经心理发育的影响,降低因母体甲状腺功能减退引起的甲状腺激素不足对子代发育商的影响。方法随机选取2014年12月-2015年12月该院收治的72例妊娠早中期亚临床甲状腺功能低下孕妇的子代为观察组,同期选取72例身体健康孕妇的子代为对照组。观察两组孕妇子代在新生儿期、12、24、36个月龄时的甲状腺功能,即游离三碘甲状腺原氨酸水平(FT_3)、游离甲状腺素水平(FT_4)、促甲状腺激素水平(TSH),并对其子代在6个月龄时进行神经心理发育评估,并对比评估结果。结果新生儿期观察组子代的TSH水平显著高于对照组,血清FT_4、FT_3水平明显低于对照组(P<0.05)。12、24、36个月龄时两组的TSH、FT_4、FT_3水平比较差异无统计学意义(P>0.05)。观察组子代综合发育商低于对照组(P<0.05),大运动和精细运动单项发育商低于对照组,差异有统计学意义(P<0.05)。结论妊娠早中期孕妇亚临床甲状腺功能减低影响子代的神经心理发育,提示应在妊娠早中期对孕妇进行亚临床甲状腺功能减退的筛查,并给予积极的治疗,将对优生优育发挥重要作用。

Objective To explore the effect of subclinical hypothyroidism on neuropsychological development of infants, reduce the effect of thyroid insufficiency caused by maternal hypothyroidism on development quotient of the infants. Methods A total of 72 infants born by pregnant women with subclinical hypothyroidism during the first and the second trimesters of prengnacy treated in the hospital from December 2014 to December 2015 were randomly selected as observation group, and 72 infants born by healthy pregnant women during the same period were se- lected as control group. Thyroid function of infants in the two groups during neonatal period, at the age of 12, 24, and 36 months were observed, the levels of free triiodothyronine （FF3 ） , free thyroxine （FT4 ） , and thyroid stimulating hormone （TSH） were detected, neuropsycho- logical development of infants in the two groups at the age of 6 months were evaluated and compared. Results The level of TSH during neonatal period in observation group was statistically significantly higher than that in control group, while the levels of serum FF4 and FT3 in observation group were statistically significantly lower than those in control group （ P〈0. 05 ）. There was no statistically significant difference in the levels of TSH, FT4, and FT3 at the age of 12, 24, and 36 months between the two groups （P〉0. 05）. The integrated development quotient of infants in observation group was statistically significantly lower than that in control group （P〈0. 05 ）, the single development quotients of gross motor and fine motor in observation group were statistically significantly lower than those in control group （ P〈0. 05 ）. Conclusion Maternal subclinical hypothyroidism during the first and the second trimesters of prengnacy affects neuropsyehologieal development of their infants, which indicates that subclinical hypothyroidism screening among pregnant women during the first and the second trimesters of prengnacy should be con- ducted, and active treatment should be provided, and those measures will play important roles in eugenics.