妊娠和（或）哺乳期抗甲状腺治疗对子代甲状腺功能和身体、智力发育的影响

摘要

目的：探讨妊娠和（或）哺乳期抗甲状腺治疗对其子代的甲状腺功能、智力和身体发育情况的影响。方法2001年9月至2007年1月选择了50例妊娠和（或）哺乳期抗甲状腺治疗的甲亢（抗甲状腺治疗组-Ⅰ组）、30例TPOAb阳性甲状腺功能正常（TPOAb阳性组-Ⅱ组）、50例健康妇女（对照组）的子代作为研究对象。测定三组母亲的婴儿在0、12、24、36个月时的甲状腺功能（FT3、FT4、TSH）、发育商、语言和功能构成、身高及体质量等指标。比较三组婴儿有无差异。结果新生儿期Ⅰ、Ⅱ组的TSH基线显著高于对照组，血清FT4、FT3水平明显低于对照组。12个月、24个月、36个月两组的TSH、FT4、FT3水平无显著性差异。Ⅰ、Ⅱ组的发育商在新生儿期、12个月、24个月、36个月均明显低于对照组（P<0.05）。Ⅰ、Ⅱ组的体格发育在新生儿期、12个月、24个月、36个月均滞后于对照组（P<0.05）。）Ⅰ、Ⅱ组的甲状腺功能和智力、身体发育无显著差异（P＞0.05）。结论妊娠和（或）哺乳期抗甲状腺治疗及妇女妊娠期TPOAb阳性可能给子代的智力、体格发育造成不良影响，同时可能引起短期的甲状腺功能异常，提示曾有甲状腺功能异常的妇女选择适当的妊娠时机、筛查和积极治疗妊娠早中期临床甲状腺异常对优生优育有其必要性，加强患甲状腺疾病的母亲及其孩子的管理十分重要。%Objective We were to investigate female during pregnancy and/or lactation received Anti-thyroid treatment effects on their offspring’s thyroid function, physical and intellectual development. Methods A total of 130 children enrolled whose mothers in Xinyi People's Hospital from September 2001 to January 2007 were divided into three groups. Among them, 50 children whose mother were hyperthyroidism patients during pregnancy and/or lactation received anti-thyroid treatment as group I. 30 children whose mother’s thyroid function were normal but TPOAb positive as group II. Additional 50 children whose mother was healthy as control group. We determinate and compared respectively all 130 children’s thyroid function(FT3, FT4, TSH), developmental quotient, physical development, height and weight when children were burn, 12, 24, 36 months old. Results TSH level in group I and II when children were newborn was signiifcantly higher than control group. Serum FT4 and FT3 level was lower than control group. However, TSH, FT4 and FT3 levels when children were 12, 24, 36 months between the two groups were no signiifcant difference. Develop quotient in group I and II was signiifcantly lower than control group respectively when children were 0, 12, 24 and 36 month(P<0.05). Physical development in group I and II was lag behind control group when children were 0, 12, 24 and 36 month (P<0.05). Thyroid function, intelligence and physical development between group I and II were no signiifcant difference(P>0.05). Conclusion Female during pregnancy and/or lactation received Anti-thyroid treatment and TPOAb positive female may have adverse effects on their children’s intellectual and physical development, and may result in temporarily abnormal thyroid function, which suggested that women with abnormal thyroid function selection the appropriate timing of pregnancy, screening and active treatment of subclinical thyroid abnormality at early and medium stage of pregnancy was of necessity for the aristogenesis. Therefore, it is important to strengthen the management of thyroid disease mothers and their children.