摘要
Abstract
Objective To investigate the risk factors of positive initial screening of thyroid stimulating hor-mone(TSH)in neonatal heel blood.Methods A total of 562 newborns delivered in the hospital from May 2020 to May 2022 were selected as the study objects.The TSH-positive children were included in the TSH-positive group,and the TSH-negative children were included in the healthy group.General data(including gender,gestational age,delivery time,birth weight)and maternal clinical characteristics[presence or absence of gestational anemia,hemoglobin level,presence or absence of gestational diabetes mellitus,fasting blood glu-cose(FBG)level,presence or absence of hypothyroidism,presence or absence of hyperthyroidism,and TSH level,free triiodothyronine(FT3)level,free thyroxine(FT4)level]were compared between the two groups.The risk factors of TSH positive initial screening in neonatal heel blood were determined by unconditional Logistic stepwise regression analysis.Receiver operating characteristic(ROC)curve was drawn to analyze the value of maternal TSH,FT3 and FT4 in the diagnosis of positive initial screening of TSH in neonatal heel blood.Results Preliminary screen-ing results showed that 17 cases of heel blood TSH preliminary screening positive(TSH-positive group),an-other 100 cases of heel blood TSH preliminary screening negative neonates were selected as healthy group.There were no significant differences in gender,gestational age,delivery time,proportion of maternal anemia during pregnancy,maternal hemoglobin level,proportion of maternal gestational diabetes,maternal FBG level,and proportion of maternal hyperthyroidism between the two groups(P>0.05);while the proportion of low birth weight newborns,the proportion of maternal hypothyroidism and the level of maternal TSH in TSH-positive group were significantly higher than those in healthy group,and the levels of maternal FT3 and FT4 in TSH-positive group were significantly lower than those in healthy group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression results showed that low birth weight,maternal hypothy-roidism,elevated maternal TSH level,decreased maternal FT3 level and decreased maternal FT4 level were the risk fac-tors for positive TSH in neonatal heel blood screening(P<0.05).The ROC curve analysis results showed that the ar-ea under the curve of initial screening positive TSH in neonatal heel blood diagnosed with maternal TSH,FT3 and FT4 were 0.713,0.718 and 0.661,respectively.Conclusion Low birth weight,maternal hypothyroidism,elevated mater-nal TSH level,decreased maternal FT3 level and decreased maternal FT4 level are risk factors for positive TSH in neonatal heel blood screening,and more attention should be paid during screening.关键词
先天性甲状腺功能减退/新生儿/促甲状腺激素/母体临床特征Key words
congenital hypothyroidism/newborn/thyroid stimulating hormone/maternal clinical character-istics分类
医药卫生
