| Congenital hypothyroidism(CH)was a disorder of thyroid function in newborns caused by genetic and environmental factors,decreased synthesis or secretion of thyroid hormones,Causes the newborns physical development and intellectual development backward,In severe cases,children can not take care of themselves or even die in adult life.CH is a major cause of preventable mental and physical retardation with early detection and simple treatment.At present,a perfect mechanism has been established for screening,diagnosis and treatment of CH at domestic and overseas.However,there was little analysis on the associated factors of CH.The occurrence of CH was not only related to genetic and external factors,but also related to the living habits of parents,pregnant women's pregnancy status and living environment.ObjectiveTo understand the detection rate of CH in Henan province from 2011 to 2017.The case control design was adopted to study the factors affecting CH in neonates and analyzed the associated factors of CH with birth length,weight,gestational age,history of hypoxia,history of jaundice,the maternal age,family history of thyroid disease,formaldehyde exposure history,radiation exposure history,medication history during pregnancy,progesterone use history,father's age and educational backgroundMethodsBased on the data of the newborn disease screening center of Henan province,to analyze the CH detection rate of neonates from 2011 to 2017.A case-control study was adopted to select the children with CH as cases between January 1st,2016 and December 31st,2017,and their 1:1 matched controls with the same gender,approximately the same birth date(±30 days)was selected from the same population.Conditional Logistic regression analysis was used to analyze the risk factors of CH incidence;Subgroup analysis,P-trend analysis,and The age of pregnant women was compared with the restricted cubic spline regression model of CH respectively was performed.ResultThe detection rate from 2011 to 2017 was 38.01/100,000,42.83/100,000,44.04/100,000,49.13/100,000,51.80/100,000,53.20/100,000 and 53.30/100,000,respectively.A total of 843 pairs of children with CH were used in the paired design case-control study.There were 387 male children and 456 female children.In all cases and contro-l pairs,Logistic regression analysis showed that higher maternal age at delivery[taken the group of 21?years old as control,the OR adj values and their 95%CI in groups of<21year,26?year old,31?years-old,?35 years old were 0.29(0.06?0.52),2.72(1.87,3.98),6.85(4.14,11.34),7.71(4.17,14.27),respectively],maternal living in the rural[OR adj(95%CI):1.87(1.15,3.11)],material family history of thyroid diseases[OR adj(95%CI):7.26(2.13,24.75)],exposure to formaldehyde[OR adj(95%CI):3.38(1.19,9.58)],material exposure to radiation[(OR adj(95%CI):7.07(3.66,21.15)],material medication intake during pregnancy[ORadj(95%CI):7.59(3.25,17.72)],material lower maternal education[(OR adj(95%CI):5.27(3.13,8.88)],Other feeding methods[OR adj(95%CI):3.25(1.67,6.53)],Progesterone intake during pregnancy[ORadj(95%CI):0.17(0.06,0.43)],father's age[OR adj(95%CI):1.32(1.24,1.40)]were statistically significant association with CH,all P<0.05.The results of subgroup analyses were consistent with those listed above.Maternal age and CH restricted cubic spline regression model were shown,the risk of CH in newborns increases with maternal age,and in male newborn and female newborn basically consistent.Conclusion1.The detection rate of newborn CH in Henan province was on the rise from 2011 to 2017,The detection rate was 53.9 per 100,000 from 2016 to 2017,higher than the national level.2.History of jaundice,family history of thyroid diseases,higher ages at delivery,living in the rural,Other feeding methods,exposure to radiation,medication intake during pregnancy,lower education level can increase CH susceptibility.3.Maternal age was risk factor for CH,and the risk of CH increased with maternal age. |
PDF Full Text Request