滨州市孕妇碘营养状况调查及其对新生儿甲状腺功能的影响

Survey on iodine nutritional status of pregnant women and thyroid function of neonates in Binzhou

目的了解不同碘营养状况对孕妇甲状腺功能和新生儿促甲状腺激素(TSH)水平的影响。方法随机选取2019年某院就诊的284名妊娠晚期孕妇(妊娠≥28周),收集尿液测定尿碘水平,采集静脉血测定TSH、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)和甲状腺过氧化物酶抗体(TPOAb)。收集其分娩足月正常新生儿生后72 h的足跟血进行TSH测定。结果滨州市孕妇尿碘在<150、150~249、250~499、>500μg/L的比例分别为18.31%、13.73%、19.01%、48.94%。41例孕妇患有甲状腺疾病(14.44%),亚甲减者25例(8.80%),甲减者16例(5.63%)。新生儿足跟血TSH水平为(2.95±2.50)mIU/L,15.32%新生儿足跟血TSH>5 mIU/L,不同碘营养水平孕妇所生新生儿足跟血TSH水平比较,差异无统计学意义。结论滨州市孕妇碘缺乏与碘过量问题并存,碘过量孕妇比例较高,新生儿TSH水平较高,孕妇碘营养状况可影响新生儿碘营养水平。

Objective To investigate the effects of different iodine nutrition status on thyroid function in pregnant women and TSH levels in newborns.Methods Two hundred and eighty-four pregnant women were selected in the third trimester of pregnancy(≥28 weeks of pregnancy)of a hospital in 2019.The morning-urine was collected to detect the levels of free triiodothyronine(FT3),free thyroxine(FT4)and sensitive thyroid stimulating hormone(sTSH).The venous blood samples were collected to detect the content of iodine in urine,chemiluminescencetthyroid peroxidase antibody(TPOAb)and thyro-globulin antibody(TGAb).Heel blood of 72 hours of normal term was collected to detect the levels of TSH.Results The ratios of urinary iodine in women in Binzhou area were below 149μg/L,150~249μg/L,250~499μg/L,and above 500μg/L were 18.31%,13.73%,19.01%,and 48.94%,respectively.There were 41 pregnant women suffering from thyroid disease(14.44%),25 pregnant women suffering from methylene chloride(8.80%),and 16 pregnant women suffering from hypothyroidism(5.63%).The neonatal heel blood TSH level was(2.95±2.50)mIU/L and 15.32%of neonatal heel blood TSH was higher than 5mIU/L.There was no significant difference in heel heel blood TSH of newborns born by pregnant women with different levels of iodine nutrition(P>0.05).Conclusion The iodine deficiency and iodine excess problems of pregnant women in Binzhou area coexist.The proportion of pregnant women with iodine excess is high,and the TSH level of newborns is high.The iodine nutrition status of pregnant women can affect the iodine nutrition level of newborns.