A Study On Thyroid Function Of Pregnant Women And Infant Neural Development In High Iodine Area

Objective:To analyze the status of iodine nutrition and thyroid function in pregnant women in high iodine areas,to understand the status of nerve development in infants in high iodine areas,and to provide the basis for the study of appropriate intervention measures in the area of water source high iodine.Methods:Using the random sampling method to select different water iodine area in Tianjin city?high iodine endemic area:water iodine>300 ug/L;high iodine area:150 ug/L<water iodine<300 ug/L;the control area:water iodine<100 ug/L?with 240,314,290pregnant women as the research object.Urine samples 25ml were collected for urine iodine measurement.Veinal blood 3ml was used to measure serum thyroid hormones and thyroid autoantibodies.and the Denver development screening test?DDST?was carried out for infants of 6⁸ months postpartum.The data were statistically analyzed by SPSS20.0 with nonparametric test,chi square test,T test and logistic regression analysis.Results:1.Analysis of iodine nutrition of pregnant women:The median urine iodine number of pregnant women in the control area,high iodine area and high iodine area were106.90ug/L,198.20 ug/L and 250.90 ug/L respectively.The median difference of urine iodine in each area was statistically significant?P<0.05?,and the difference of urine iodine level between pregnant women in the same area was not statistically significant?P>0.05?.2.Analysis of the frequency of urine iodine in pregnant women:In the control area,68.6%of pregnant women were pregnant with urine iodine<150 ug/L,20.3%of pregnant women's urine iodine was between 150²50 ug/L,8.6%of pregnant women's urine iodine was 250⁵00 ug/L,and 2.4%of pregnant women were more than 500 ug/L.The proportion of pregnant women in high iodine area was 38.2%,24.5%,30.6%,6.7%,respectively.The proportion of pregnant women in high iodine area was 22.5%,27.5%,35%and 15%,respectively.There was no significant difference in frequency distribution of urinary iodine among pregnant women in the same area?P>0.05?.3.The trend of the change of thyroid hormone in pregnant women:The level of FT₃decreased gradually with the progress of pregnancy,and the level of FT₄ decreased gradually with the progress of pregnancy;the level of early TSH pregnancy was lower and the progresses in pregnancy increased;the difference of thyroid hormone levels in different pregnant women in different regions was statistically significant?P<0.05?.4.There were significant differences in FT₃ and FT₄ levels between pregnant women in different regions?H=38.829,P<0.001;H=11.989,P=0.002?,high iodine endemic area>control area>high iodine area.The difference of TSH level was not statistically significant?P>0.05?.There was no significant difference in FT₄ and TSH levels between pregnant women in different areas?P>0.05?,but the difference in FT3 level was statistically significant?H=9.434,P=0.009?,high iodine area>high iodine endemic area>control area.There was no significant difference in the levels of FT₃,FT₄ and TSH between pregnant women at different stages of pregnancy?P>0.05?.5.The relationship between antibody level,urinary iodine level and thyroid hormone level:There was no significant difference in FT₃,FT₄ and TSH levels between TGAb,TPOAb positive and negative subjects in the thyroid gland.The difference of FT₄level between different iodine nutrition levels in pregnant women in the early pregnancy was statistically significant?H=9.457,P=0.024?,and the difference between FT₄ and TSH was statistically significant between pregnant women at different iodine levels in the middle pregnancy?H=8.036;P=0.045;H=8.965,P=0.030?.6.Monitoring and analysis of thyroid function:In the survey,there were 830 effective serum samples,221 cases of abnormal thyroid function,26.6%abnormal detection rate,6 cases of hyperthyroidism,0.72%detection rate,1 cases of hyperthyroidism and hypothyroidism,the detection rate was 0.12%,the subtract detection rate was 24,the detection rate was 2.90%,4 cases were detected in low FT₄ blood disorder,two0.48%was established at the beginning of the year;TGAb Positive and TPOAb positive were detected in 45 cases and 44 cases respectively,the detection rates were5.47%and 5.23%respectively.7.The neurodevelopmental survey of infant:No abnormal infants were found from the results of DDST screening.The rate of retardation?one term?was 7.87%,and most of the retarded infants were delayed by the fine motor area and the large motor area,and the rate of retardation was 3.94%and 3.54%,respectively.Conclusion:The increase of incidence of hypothyroidism,hypothyroidism and hypothyroidism in pregnant women with high water iodine was not found.The effect of high water iodine on human health was remained to be further studied.