孕中期甲状腺激素和血脂水平的相关性及其对新生儿出生体质量的影响

Correlation between Thyroid Hormone and Blood Lipid Level in the Second Trimester of Pregnancy and its Effect on the Birth Weight of Newborns

【目的】探讨孕中期(妊娠12?16周)孕妇游离甲状腺素(FT4)、游离三碘原氨酸(FT3)、促甲状腺激素(TSH)与三酰甘油(TG)、总胆固醇(TC)的相关性及其对新生儿出生体质量的影响。【方法】选取2018年1?12月在上海交通大学医学院附属国际和平妇幼保健院和上海松江区妇幼保健院按期产检的孕妇10574例,分析孕12?16周甲状腺激素(FT4、FT3、TSH)和血脂水平(TG、TC)的相关性,以其对新生儿出生体质量的影响。【结果】孕妇FT4水平与TG、TC均呈负相关,孕妇较高的FT3水平与较高的TG、较低TC水平相关(均P<0.05);孕妇TSH与TG呈负相关(P<0.05),TSH与TC无相关性(P=0.79)。FT4水平降低,TG水平升高增加大于胎龄儿(LGA)风险;FT4水平升高,TG水平降低增加女婴小于胎龄儿(SGA)风险;孕妇FT4水平降低联合TG水平升高对新生儿出生体质量呈交互作用,出生男婴的LGA风险增加[OR=1.79,95%CI(1.38,2.33)]。【结论】孕妇FT4水平降低与TG水平升高发生男婴LGA风险增加,监测甲状腺激素和血脂水平,并采取相应的措施,可降低新生儿发生SGA、LGA的风险。

【Objective】To investigate the correlation of free thyroxine(FT4),free triiodothyronine(FT3),thyrotropin(TSH),triglyceride(TG),total cholesterol(TC)and their effects on the birth weight of the newborn in the second trimester(12?16 weeks).【Methods】A total of 10,574 pregnant women was selected from the International Peace Maternal and Child Health Center Affiliated to Shanghai Jiaotong University Medical College and Songjiang District Maternal and Child Health Center of Shanghai from January to December 2018.The correlation between thyroid hormone(FT4,FT3,TSH)and blood lipid level(TG,TC)at the 12th to 16th weeks of pregnancy was analyzed to determine the effect on the birth quality of newborns.【Results】The level of FT4 in pregnant women was negatively correlated with TG and TC,the level of FT3 in pregnant women was negatively correlated with TG and TC(P<0.05),TSH was negatively correlated with TG(P<0.05),and TSH was not correlated with TC(P=0.79).FT4 level decreased,TG level increased more than the risk of gestational age infants(LGA);FT4 level increased,TG level decreased increased the risk of SGA in female infants;the combination of FT4 level decreased in pregnant women and TG level increased had an interactive effect on newborn birth weight,LGA risk increased in male infants[OR=1.79,95%CI(1.38,2.33)].【Conclusion】The risk of LGA of male baby is increased when FT4 level of pregnant women decreases and TG level increases.Monitoring thyroid hormone and lipid level and taking corresponding measures could reduce the risk of SGA and LGA.