Newborn Thyroid-Stimulating Hormone Dynamicity as per the Antenatal and Perinatal Factors

S. Patel, P. Padhi, T. Naik, R. Nanda, E. Mohapatra, S. Agrawal
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Abstract

Background: Recent surge in the diagnoses of congenital hypothyroidism (CH) has necessitated the measurement of newborn TSH levels and understanding of the way various antenatal and perinatal factors influence its dynamicity. It is a cross-sectional study on newborns delivered or admitted to the All India Institute of Medical Sciences Raipur (AIIMS Raipur), Chhattisgarh, India. Methods: Dried blood spot analysis of newborn thyroid-stimulating hormone (nTSH) was carried out on 1,216 newborns after ethical clearance. The TSH levels were presented in percentage to determine the distribution in the study population. The mean values were compared within the groups categorized under each variable. The newborns' variables in this study included birth weight, Ponderal index, and neonatal complications. The studied maternal variables included antenatal visits, maternal age, gestational age, anemia, and mode of delivery. Results: The mean (standard error of the mean) for nTSH was obtained at 3.37 (0.12) mIU/L and 97% of newborns were below 8 mIU/L. Mean nTSH was significantly high in mothers older than 30 years (P=0.019) and those with anemia during the antenatal period (p <0.001). It was significantly raised in babies with complications (P=0.004). Besides, higher values were also observed in low birth weight babies and those with low Ponderal Index. Higher nTSH was observed among newborns born to mothers with a thyroid disorder, those delivered prematurely and/or by cesarean section, and those with no antenatal visits. Conclusion: It is highly essential to take a precautionary note on the antenatal status of mothers in terms of advanced age, premature delivery, associated maternal diseases, mode of delivery, newborn’s birth weight, and complications which are supposed to influence the dynamicity of thyroid hormones in newborns and result in CH.
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根据产前和围产期因素的新生儿促甲状腺激素动态
背景:最近先天性甲状腺功能减退症(CH)的诊断激增,有必要测量新生儿TSH水平,并了解各种产前和围产期因素影响其动态的方式。这是一项针对在印度恰蒂斯加尔邦的全印度医学科学研究所(AIIMS Raipur)分娩或入院的新生儿的横断面研究。方法:对1216例经伦理检查的新生儿进行新生儿促甲状腺激素(nTSH)干血斑点分析。TSH水平以百分比表示,以确定在研究人群中的分布。在每个变量下分类的组内比较平均值。本研究中新生儿的变量包括出生体重、Ponderal指数和新生儿并发症。研究的产妇变量包括产前检查、产妇年龄、胎龄、贫血和分娩方式。结果:新生儿nTSH均值(均数标准误差)为3.37 (0.12)mIU/L, 97%新生儿nTSH低于8 mIU/L。年龄在30岁以上的孕妇(P=0.019)和产前有贫血的孕妇(P <0.001)的平均nTSH较高。有并发症的婴儿死亡率明显升高(P=0.004)。此外,低出生体重儿和低Ponderal指数儿也有较高的数值。在患有甲状腺疾病的母亲、早产和/或剖宫产的母亲和没有产前检查的母亲所生的新生儿中,观察到较高的nTSH。结论:对高龄、早产、相关母体疾病、分娩方式、新生儿出生体重和并发症等可能影响新生儿甲状腺激素动态并导致CH的母亲产前状况进行预防是非常必要的。
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