广西地区早产低体质量新生儿甲状腺功能减退症发生率与其出生体质量和胎龄的相关性分析

Analysis on the incidence of congenital hypothyroidism with gestational age and birth weight in Guangxi Zhuang Autonomous Region

目的 探讨广西地区早产低体质量新生儿甲状腺功能减退症(CH)发生率与胎龄和出生体质量的关系。方法 收集2015年1月—2020年12月广西地区出生的新生儿血样,采用时间分辨荧光免疫分析法测定其促甲状腺激素(TSH)水平,将初筛结果大于切割值(TSH>8μIU/ml)者召回进行确诊检查。分别对不同胎龄和出生体质量新生儿进行分组,对早产低体质量的新生儿甲状腺功能减低症的发生率与早产低体质量新生儿的胎龄及出生体质量的相关性进行分析。结果 符合标准的新生儿筛查检测样本合计842 764例,第1次筛查阳性样本13 639例,阳性率为1.62%;甲状腺功能减低症确诊患儿491例,总患病率为1/1 716。其中早产儿患病率为1/665;足月儿患病率为1/1 919;过期产儿患病率为1/394(χ^(2)=61.516,P<0.05)。低体质量儿患病率为1/500;正常体重儿患病率为1/2 018;巨大儿患病率为1/1949(χ^(2)=177.407,P<0.05)。早产低体质量新生儿共筛查25 992例,初筛阳性496例,甲状腺功能减低症确诊67例,甲状腺功能减低症总患病率为1/388。在早产低体质量患儿中,体质量越低,患病率越高。孕周越小,患病率增高。结论 早产儿的甲状腺功能减低症的发病率高于足月儿的发病,低出生体质量新生儿甲状腺功能减低症的发病率远高于正常体质量和巨大儿。早产低体质量的新生儿孕周增加和新生儿出生体质量增加,甲状腺功能减低症患病率降低。在妊娠期应及时复查甲状腺功能,一经发现要及时诊断和治疗,有助于降低新生儿甲状腺功能减低症的发生。

Objective To investigate the relationship between neonatal congenital hypothyroidism(CH) and gestational age, and birth weight in Guangxi Zhuang Autonomous Region.Methods Blood samples of newborns in Guangxi Zhuang Autonomous region from January 2015 to December 2020 were collected.The values of thyroid-stimulating hormone(TSH) were determined by time-resolved fluorescent immunoassay.The neonates with positive results of primary screening were recalled for definite diagnosis.The newborns were grouped based on their gestational age and birth weight, and the incidence of congenital hypothyroidism in each group were compared.Results A total of 842 764 samples were screened, of which 13 639 were positive for TSH,with a positive rate of 1.62%.A total of 491 children with CH were diagnosed, and the total prevalence was 1/1 716.Among the 491 cases, the prevalence of premature infants,full-term infants and post-term infants was 1/665,1/1 919,1/394,respectively, there was statistically significant difference(χ~2=61.516,P<0.05).And the prevalence of low weight infants, normal weight infants and great infants was 1/500,1/2 018,1/1 949,respectively, there was statistically significant difference(χ~2=177.407,P<0.05).Conclusion The prevalence of congenital hypothyroidism is associated with the birth weight and gestational age.For preventing congenital hypothyroidism, it is important to reduce the probability of early delivery and low birth weight.Thyroid function should be reviewed in time during pregnancy, and diagnosis and treatment should be timely once found, which is helpful to reduce the occurrence of neonatal hypothyroidism.