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新生儿先天性甲状腺功能减低症危险因素的Meta分析
Risk factors for neonatal congenital hypothyroidism: a Meta analysis
目的 探讨新生儿先天性甲状腺功能减低症（congenital hypothyroidism，CH）的危险因素，为CH的预防提供参考依据。方法 系统收集中国生物医学文献数据库、中国知网、维普中文期刊数据库、万方数据库、PubMed、Web of Science、Embase、SpringerLink、Elsevier/ScienceDirect等数据库自建库至2020年8月1日公开发表有关新生儿CH危险因素的研究文献，采用R 3.6.2和RevMan 5.3软件进行Meta分析。结果 共纳入20篇文献，其中病例对照研究13篇，现况研究7篇。病例组3 579例，对照组7 985例，样本量合计11 564例。Meta分析显示，母亲高龄（OR=2.111，95% CI：1.275~3.493）、妊娠合并甲状腺疾病（OR=3.365，95% CI：1.743~6.500）、妊娠糖尿病（OR=2.158，95% CI：1.545~3.015）、妊娠期焦虑（OR=3.375，95% CI：2.133~5.340）、妊娠期用药（OR=2.774，95% CI：1.344~5.725）、妊娠期接触辐射（OR=3.262，95% CI：1.950~5.455）、甲状腺疾病家族史（OR=8.706，95% CI：5.991~12.653）、低出生体重（OR=2.674，95% CI：1.895~3.772）、巨大儿（OR=1.657，95% CI：1.187~2.315）、早产儿（OR=2.567，95% CI：2.070~3.183）、过期产儿（OR=2.083，95% CI：1.404~3.091）、双胎及多胎（OR=3.455，95% CI：1.958~6.096）、出生缺陷（OR=6.038，95% CI：3.827~9.525）是新生儿CH的危险因素。结论 母亲高龄、妊娠合并甲状腺疾病、妊娠糖尿病、妊娠期焦虑、妊娠期用药、妊娠期接触辐射、甲状腺疾病家族史、低出生体重、巨大儿、早产儿、过期产儿、双胎及多胎、出生缺陷可能增加新生儿CH的患病风险。
Objective To investigate the risk factors for congenital hypothyroidism (CH) in neonates, and to provide a reference for the prevention of CH. Methods The databases including China Biomedical Literature Service System, China National Knowledge Infrastructure, Wanfang Data, and Weipu Periodical Database, PubMed, Web of Science, Embase, SpringerLink, and Elsevier/ScienceDirect were searched for studies on the risk factors for CH in neonates published up to August 1, 2020. R 3.6.2 and RevMan 5.3 software were used to perform a Meta analysis. Results A total of 20 studies were included, with 13 case-control studies and 7 cross-sectional studies. There were 11 564 neonates in total, with 3 579 neonates in the case group and 7 985 neonates in the control group. The Meta analysis showed that advanced maternal age (OR=2.111, 95%CI: 1.275-3.493), thyroid disease during pregnancy (OR=3.365, 95%CI: 1.743-6.500), gestational diabetes mellitus (OR=2.158, 95%CI: 1.545-3.015), anxiety (OR=3.375, 95%CI: 2.133-5.340), medication during pregnancy (OR=2.774, 95%CI: 1.344-5.725), radiation exposure during pregnancy (OR=3.262, 95%CI: 1.950-5.455), family history of thyroid disease (OR=8.706, 95%CI: 5.991-12.653), low birth weight (OR=2.674, 95%CI: 1.895-3.772), fetal macrosomia (OR=1.657, 95%CI: 1.187-2.315), preterm birth (OR=2.567, 95%CI: 2.070-3.183), post-term birth (OR=2.083, 95%CI: 1.404-3.091), twin pregnancy or multiple birth (OR=3.455, 95%CI: 1.958-6.096), and birth defects (OR=6.038, 95%CI: 3.827-9.525) were risk factors for CH in neonates. Conclusions Advanced maternal age, gestational thyroid disease, gestational diabetes mellitus, anxiety, medication during pregnancy, radiation exposure during pregnancy, family history of thyroid disease, low birth weight, fetal macrosomia, preterm birth, post-term birth, twin pregnancy or multiple pregnancy, and birth defects may increase the risk of CH in neonates.
先天性甲状腺功能减低症 / 危险因素 / Meta分析 / 新生儿
Congenital hypothyroidism / Risk factor / Meta analysis / Neonate
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