Open AccessPerinatal risk factors for congenital hypothyroidism
Author(s) -
Jinfu Zhou,
Jinying Luo,
Junyu Lin,
Yanli Zeng,
XiaoLong Qiu,
Wenbin Zhu,
Guanghua Liu
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000020838
Subject(s) - medicine , retrospective cohort study , pediatrics , offspring , levothyroxine , thyroid disease , discontinuation , thyroid function , pregnancy , population , obstetrics , birth weight , congenital hypothyroidism , cohort study , low birth weight , thyroid , genetics , environmental health , biology
Congenital hypothyroidism (CH) is one of the most common neonatal endocrine diseases. This retrospective cohort study aimed to identify the potential perinatal risk factors for CH and to differentiate between transient and permanent CH (TCH and PCH, respectively) as well as determine their prevalence in a southeastern Chinese population. This study was based on an 18-year surveillance of a neonatal CH screening program in a large tertiary hospital. A retrospective review of the maternal and neonatal perinatal exposures was conducted. Of the 205,834 newborns screened between 2000 and 2018, 189 were diagnosed with CH (1/1089). Among the 131 CH patients who again underwent thyroid function testing (TFT) after discontinuation of levothyroxine at the age of 3 years, 61 (46.6%) were diagnosed with PCH and 70 (53.4%) were diagnosed with TCH. In the maternal characteristics model, women aged 35 years or older and those who had thyroid disease and/or diabetes mellitus during pregnancy had increased risk of having an offspring with CH ( P = .001, .000, and .001, respectively). Significant associations were found with regard to parity and the risk of CH in the offspring ( P = .000). In the neonatal characteristics model, infants with female sex, preterm birth, post-term birth, low birth weight, other birth defects, and those born as part of multiple births ( P = .011, .034, .001, .000, .000, and .003, respectively) had increased risk of CH. The rate of newborns with other birth defects was higher in the PCH group than that in the TCH group ( P = .008), whereas the rate of maternal thyroid disease, newborns with low birth weight, and newborns with preterm birth was higher in the TCH group than that in the PCH group ( P = .041, .020, and .013, respectively). The levothyroxine dose (μg/kg/day) at 1 year, 2 years, and 3 years old was significantly lower in the TCH group than that in the PCH group ( P = .000, .000, and .000, respectively). Perinatal factors should be considered during the diagnosis and treatment of CH.