Effect Of Intrauterine Infection On Thyroid Function In Very And Moderately Preterm Infants

Object:To study the effect of intrauterine infection(IAI)on thyroid function in very and moderately preterm infants.Methods:Premature infants with gestational age of 28-34 weeks who were born in the obstetrics department of Qingdao women’s and children’s Hospital from January 2019 to June 2021 and received NICU treatment were selected.A total of 259 cases were included after excluding children born outside the hospital,with incomplete data,thyroid disease and incomplete data.According to the prenatal clinical manifestations of the mother and the results of placental pathological examination,it is divided into clinical CA Group,HCA group and non CA Group.The clinical CA Group and HCA group are collectively referred to as CA Group.According to the gestational age of preterm infants,they were divided into very preterm infants group and moderate preterm infants group.The venous blood FT3,FT4,TSH and their abnormal rates,common diseases and physical development of preterm infants in each group were compared,and the preterm infants whose thyroid hormone was retested from January2020 to June 2021 were examined by thyroid B-ultrasound.Collect and analyze the relevant data that may lead to neonatal thyroid dysfunction,to understand the differences of basic data and treatment between the different groups,and explore the effects of IAI on thyroid function and B-ultrasound in very and moderate preterm infants.Result:1.Among very preterm infants,there was no significant difference in FT3,FT4,TSH,abnormal rate and use rate of Euthyrox among CCA group,HCA group and non CA Group(P > 0.05).2.Among very preterm infants,there was no significant difference in corrected gestational age,twice FT3 and its abnormal rate,twice TSH and its abnormal rate and the use rate of Euthyrox between CA Group and non CA Group(P > 0.05).The concentration of FT4 in CA Group was lower than that in non CA Group(P < 0.05).There was no significant difference in the abnormal rate of FT4 in CA Group(P >0.05).The retested FT4 of preterm infants in the two groups was within the normal range.3.In very preterm infants,thyroid ultrasound in CA Group and non CA Group did not find morphological changes such as thyroid dysplasia,absence,ectopic,swelling and abnormal mass,and there was no obvious abnormality in blood supply.The length,width,thickness and isthmus thickness of left and right thyroid lobes were measured,and there was no significant difference in thyroid volume(P > 0.05).4.Among very preterm infants,there was no significant difference in the growth of head circumference,weight and body length between CA Group and non CA Group(P > 0.05).5.Among moderate preterm infants,there was no significant difference in FT3,FT4,TSH,abnormal rate and use rate of youjiale among CCA group,HCA group and non CA Group(P > 0.05).6.Among moderate preterm infants,there was no significant difference in corrected gestational age,two times of FT3,FT4,TSH and their abnormal rates,and the use rate of Euthyrox between CA Group and non CA Group(P > 0.05).The FT4 of preterm infants in the two groups was within the normal range.7.In moderate birth infants,thyroid ultrasound of preterm infants in CA Group and non CA Group did not find morphological changes such as thyroid dysplasia,absence,ectopic,swelling and abnormal mass,and there was no obvious abnormality in blood supply.The length,width,thickness and isthmus thickness of left and right thyroid lobes were measured,and there was no significant difference in thyroid volume(P > 0.05).8.Among moderate preterm infants,there was no significant difference in the growth of head circumference,weight and body length between CA Group and non CA Group(P > 0.05).9.In terms of basic data,common diseases and special drug use of mothers and preterm infants during hospitalization: in the very preterm infants group,the use rate of pulmonary surfactant(PS)in preterm infants in non CA Group was higher than that in CCA and HCA group(P < 0.05);In the group of moderate preterm infants,the twin rate in HCA group was lower than that in non CA Group,the rate of prenatal hormone use was higher than that in non CA Group,and the incidence of respiratory failure,respiratory distress syndrome(RDS)and respiratory support time were lower than those in non CA Group(P < 0.05)10.There was no significant difference in FT4,TSH,abnormal rate and the use rate of Euthyrox between the two groups(P > 0.05);The concentration of FT3 in the very preterm group was lower than that in the moderate preterm group,and the abnormal rate was higher than that in the moderate preterm group(P < 0.05).Conclusion:1.Intrauterine infection can not be confirmed,including clinical chorioamnionitis and histological chorioamnionitis,which can affect the thyroid hormone level,size and volume of very premature infants in the early postnatal period;It can not be confirmed that intrauterine infection can affect the thyroid hormone level,size and volume of moderate preterm infants in the early postnatal period.2.Although there are differences in different forms of intrauterine infection among twins,maternal prenatal hormone use,respiratory support,pulmonary surfactant use in preterm infants,respiratory failure in preterm infants,and respiratory distress syndrome,they have no effect on thyroid hormone levels in very and moderate preterm infants.3.Gestational age has a significant effect on the thyroid hormone level of preterm infants.The smaller the gestational age is,the lower the FT3 concentration is.