Objective To by analyzing the outcomes of thyroid function screening for pregnant women in the first trimester and tracing the screening outcomes of their neonates, we evaluate the management status of thyroid diseases during pregnancy, and find the reason of the raising positive rate of the neonatal screening. Method 1849 pregnancy women were divided into six groups according to their thyroid function in the first trimester, while their neonates were divided into three groups according to the neonatal screening outcomes. We compared the neonatal screening outcomes among six pregnancy women groups with Chi square test. Result There was no neonatal screening positive case in all the hypothyroidism pregnancy. In normal thyroid function pregnancy, neonatal screening positive rate in TSH>2.5mIU/L group is three folds of it in TSH≤2.5mIU/L group. In subclinical hypothyroid pregnancy, the percentage of neonatal heel blood TSH≥5mIU/L reached 37.9%. Conclusion We should pay more attention on thyroid function monitoring and iodine status in subclinical hypothyroid and normal thyroid function with TSH>2.5mIU/L pregnancy to improve neonatal thyroid function.%目的 通过统计妊娠早期甲状腺功能(甲功)筛查的结果,并追踪其新生儿足跟血促甲状腺素(thyroid stimulating hormone,TSH)筛查结果,评估妊娠期甲状腺疾病管理的现状,探寻新生儿TSH筛查阳性率上升的原因.方法 选择2014年1月1日至2014年12月31日在本院产科产检并分娩的孕妇及其新生儿为研究对象.根据妊娠早期甲功筛查结果,将1849例孕妇分为6组:可疑甲亢组、甲功正常且TSH≤2.5mIU/L组(正常对照组)、甲功正常且TSH>2.5mIU/L组(TSH接近上限组)、亚临床甲状腺功能减低组(亚临床甲减组)、临床甲状腺功能减低组(甲减组)及单纯低甲状腺素血症组;新生儿根据足跟血TSH水平分为筛查阴性且<5mIU/L组、筛查阴性且≥5mIU/L组及筛查阳性(TSH≥10mIU/L)组.比较各组孕妇新生儿筛查结果的差异.结果 甲减组孕妇的新生儿中没有先天性甲减筛查阳性者;妊娠早期甲功正常的女性中,TSH>2.5mIU/L组其新生儿筛查阳性率为TSH≤2.5mIU/L组的3.2倍;亚甲减的女性中,新生儿足跟血筛查阴性且TSH≥5mIU/L的比例为37.9%.结论 应加强亚甲减及甲功正常但TSH>2.5mIU/L孕妇孕期甲状腺功能及碘营养状态监控,以改善新生儿甲状腺功能.
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