母亲相关因素与新生儿先天性甲状腺功能减低症易感性的病例对照研究

Association of related maternal factors with susceptibility to congenital hypothyroidism: a case-control study

摘要:

目的 研究母亲相关因素与新生儿先天性甲状腺功能减低症（CH）易感性的关联。方法 采用病例-对照研究设计，以2016年1月1日至2017年12月31日在河南省新生儿疾病筛查中心确诊的CH新生儿作为病例，按照1：1比例匹配同性别和出生日期相近的健康新生儿作为对照。采用条件logistic回归及相加相乘交互作用分析评估新生儿CH易感的风险因素。结果 该期间共筛查新生儿2 771 661例，确诊CH 1 494例，粗发病率53.9/10万。完成电话问卷调查且数据合格的CH患儿、对照共843对。条件logistic回归分析显示，母亲生育年龄大、学历低、居住在农村、甲状腺疾病家族史、孕期甲醛接触史、孕期射线接触史、孕期用药史是新生儿CH发生的风险因素（均P < 0.05），而母亲年龄低、孕期使用黄体酮类保胎药是新生儿CH的保护因素（均P < 0.05）。结论 母亲生育年龄大、学历低、居住在农村、甲状腺疾病家族史、孕期甲醛接触史、孕期射线接触史及孕期用药史可增加新生儿CH的易感性。

Abstract:

Objective To study the association of related maternal factors with the susceptibility to congenital hypothyroidism (CH) in neonates. Methods A case-control study was designed. The neonates who were diagnosed with CH in Neonatal Screening Center of Henan Province from January 1, 2016 to December 31, 2017 were enrolled as cases. Healthy neonates, matched for sex and age were enrolled as controls. A conditional logistic regression analysis and additive and multiplicative interaction analyses were used to identify the risk factors for susceptibility to CH. Results A total of 2 771 661 neonates were screened during this period, among whom 1 494 neonates were diagnosed with CH, with a crude incidence rate of 53.9/100 000. A total of 843 pairs of the cases and the controls completed the telephone survey and provided qualified data. The conditional logistic regression analysis showed that an older maternal age at delivery, a low educational level in mothers, living in the rural area, a family history of thyroid diseases, histories of exposure to formaldehyde during pregnancy, exposure to radiation during pregnancy, and medication during pregnancy, were risk factors for CH (P < 0.05), while low maternal age at delivery and progesterone intake during pregnancy were protective factors against CH (P < 0.05). Conclusions An older maternal age at delivery, a low educational level in mothers, living in the rural area, a family history of thyroid diseases, and histories of exposure to formaldehyde during pregnancy, exposure to radiation during pregnancy and medication during pregnancy may increase the susceptibility to CH in neonates.