Effects of clinical features of neonates and mothers on the screening of congenital hypothyroidism / 天津医药

ABSTRACT

@# Objective Toinvestigatetheclinicalfeaturesofneonatesandmothersonthescreeningofcongenital hypothyroidism(CH),andtoprovideabasisforavoidingthemisseddiagnosisofCH.Methods Atotalof206neonateswith positive thyroid stimulating hormone (TSH) screening were collected from January 2016 to November 2017, and 206 neonateswithnegativeTSHwererandomlyselectedoverthesameperiodasnormalcontrolgroupaccordingto1∶1ratio.The impactofneonatalsex,gestationalage,bodyweightandmaternalcomorbidityonCHscreeninganddiagnosiswasanalyzed inthetwogroups.Results ThebodyweightofneonateswithpositiveTSHscreeningwaslowerthanthatofnormalnewborn infants(P＜0.05),whiletherewerenosignificantdifferencesinsex,gestationalage,theproportionofpreterm,matureand post-termdeliverybetweentwogroups.ComparedwithnormalTSHscreening,theproportionofmotherwithhypothyroidism andTSHlevelwassignificantlyhigherinscreeningpositivegroup,butFT3andFT4levelswerelower(P＜0.05).Therewere no significant differences in the ratio of gestational diabetes mellitus, anemia, subclinical hypothyroidism and hyperthyroidism,hemoglobinandfastingglucosebetweenthetwogroupsofmothers.Comparedwithconfirmednormalgroup (n=198),thebodyweightwaslowerinconfirmedCHgroup(n=8),andtheproportionofmotherwithhypothyroidismandTSH levelwassignificantlyhigherinconfirmedCHgroup,FT3andFT4levelswerelower(P＜0.05).Therewerenosignificant differences in sex, gestational age, the ratio of subclinical hypothyroidism and hyperthyroidism between CH group and confirmed normal group. Conclusion Neonatal low body weight and maternal hypothyroidism significantly affect the screening and diagnosis of CH. Special attention should be paid to clinical screening of CH in order to avoid missed diagnosis.