妊娠中期妇女亚临床甲状腺异常对后代智力发育影响的研究
임신중기부녀아림상갑상선이상대후대지력발육영향적연구
Effect of maternal subclinical thyroid abnormalities on offspring's intellectual development
  • 万方数据
    中华内分泌代谢杂志 중화내분비대사잡지
    CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
    2008年 6期 601-604 ,共4页

    李元宾%滕卫平%单忠艳%张丽%赵亚茹%于晓会%李玉姝%王微微%赵云静%华天懿%杨柳%范晨玲%王红%郭锐

    리원빈%등위평%단충염%장려%조아여%우효회%리옥주%왕미미%조운정%화천의%양류%범신령%왕홍%곽예

    妊娠%亚临床甲状腺异常%甲状腺过氧化物酶抗体%后代%智力发育 妊娠%亞臨床甲狀腺異常%甲狀腺過氧化物酶抗體%後代%智力髮育
    임신%아림상갑상선이상%갑상선과양화물매항체%후대%지력발육
    Pregnancy%Subclinical thyroid abnormality%Thyroid peroxidase antibodies%Offspring%Intellectual development
    目的 研究妊娠16～20周妇女亚临床甲状腺异常[包括亚临床甲状腺功能减退症(甲减),低T4血症和甲状腺功能正常但甲状腺过氧化酶抗体(TPOAb)阳性]对后代智力发育和运动能力的影响.方法 选择1 268名妊娠16～20周妇女2年前保存的血清,测定其TSH、TT4、FT4和TPOAb.应用妊娠特异的甲状腺功能参考值,筛查获得亚临床甲减18例,低T4血症者19例,甲状腺功能正常但TPOAb阳性者34例.按1:2比例选择同批142名甲状腺功能正常且TPOAb阴性同孕龄妇女做对照,对她们的后代在25～30月龄时进行智力和运动发育指数测评.结果 妊娠16～20周母亲亚临床甲减组后代智力评分为(109.89±13.81)分,比对照组低8.88分(P<0.01);运动评分(108.11±9.93)分,比对照组低9.98分(P<0.01).低T4血症组后代的智力评分为(112.32±15.10)分,比对照组低9.30分(P<0.01);运动评分(112.21±12.26)分,比对照组低7.57分(P<0.01).甲状腺功能正常TPOAb阳性组后代的智力评分为(112.70±20.64)分,比对照组低10.56分(P<0.01);运动评分(110.64±12.49)分,比对照组低9.03分(P<0.01).结论 妊娠16～20周妇女亚临床甲状腺功能异常皆有可能给后代智力和运动发育造成不良影响,提示筛查和治疗妊娠前半期亚临床甲状腺异常有其必要性.
    목적 연구임신16～20주부녀아림상갑상선이상[포괄아림상갑상선공능감퇴증(갑감),저T4혈증화갑상선공능정상단갑상선과양화매항체(TPOAb)양성]대후대지력발육화운동능력적영향.방법 선택1 268명임신16～20주부녀2년전보존적혈청,측정기TSH、TT4、FT4화TPOAb.응용임신특이적갑상선공능삼고치,사사획득아림상갑감18례,저T4혈증자19례,갑상선공능정상단TPOAb양성자34례.안1:2비례선택동비142명갑상선공능정상차TPOAb음성동잉령부녀주대조,대저문적후대재25～30월령시진행지력화운동발육지수측평.결과 임신16～20주모친아림상갑감조후대지력평분위(109.89±13.81)분,비대조조저8.88분(P<0.01);운동평분(108.11±9.93)분,비대조조저9.98분(P<0.01).저T4혈증조후대적지력평분위(112.32±15.10)분,비대조조저9.30분(P<0.01);운동평분(112.21±12.26)분,비대조조저7.57분(P<0.01).갑상선공능정상TPOAb양성조후대적지력평분위(112.70±20.64)분,비대조조저10.56분(P<0.01);운동평분(110.64±12.49)분,비대조조저9.03분(P<0.01).결론 임신16～20주부녀아림상갑상선공능이상개유가능급후대지력화운동발육조성불량영향,제시사사화치료임신전반기아림상갑상선이상유기필요성.
    Objective To study the effect of maternal subclinical thyroid abnormalities [including subclinical hypothyroidism, hypothyroxinemia and positive anti-thyroid peroxidase antibody (TPOAb) with normal thyroid function] in women during 16-20 weeks of gestation on offspfing's intellectual development and motor function. Methods Sera from 1 268 women during 16-20 weeks of gestation (collected 2 years ago) were obtained and thyroid stimulating hormone (TSH), total thyroxine (TT4), free thyroxine (FT4) and TPOAb levels were measured. Pregnant specific thyroid function reference ranges were used to screen for subclinical hypothyroidism (18 cases), hypothyroxinemia (19 cases) and positive TPOAb (34 cases). From the same cohort, a total of 142 pregnant women who were euthyroid with negative TPOAb were selected as controls (a case: control ratio of 1 : 2). Intellectual and motor development score evaluations were performed in their children at 25-30 months of age. Results In the group of pregnant women with subclinical hypothyroidism, the offspring' s intelligence score was (109.89±13.81) points, which was 8.88 points lower than in the control group (P < 0.01). Similarly, the motor score of the offspring was (108.11±9.93) points, which was 9.98 points lower than in the control group (P < 0.01). In the pregnant women with hypothyroxinemia, the offspring's intelligence score was (112.32±15.10) points, 9.30 points lower than in the control group (P <0.01); the motor score was (112.21±12.26) points, 7.57 points lower than in the control group (P < 0.01). In the pregnant women with positive TPOAb and euthyroid function, the offspring's intelligence score was (112.70±20.64) points, 10.56 points lower than in the control group (P < 0.01); the motor score was (110.64±12.49) points, 9.03 points lower than in the control group (P < 0.01). Conclusion Maternal subclinical thyroid abnormality between 16-20 weeks of gestation adversely may affect offspring intellectual and motor development, suggesting the necessity for screening and treatment of maternal subclinical thyroid abnormality in the early stages of pregnancy.
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