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Thyroid:早孕期孕妇甲状腺功能与儿童注意力缺陷多动障碍的关系

2019-08-26 xing.T MedSci原创

由此可见,该研究没有发现孕妇甲状腺功能与儿童多动症之间存在关联的明确证据。

甲状腺激素对于胎儿大脑发育至关重要。有证据表明,较低和较高母体甲状腺激素可能对儿童神经发育结局产生不利影响,但对行为问题的影响仍不清楚。近日,甲状腺疾病领域权威杂志Thyroid上发表了一篇研究文章,研究人员分析了妊娠前18周内母体促甲状腺激素(TSH)和游离甲状腺素(FT4)浓度与儿童注意力缺陷多动障碍(ADHD)之间的关系。

研究人员从3个基于人群的前瞻性出生队列中选择了7669对母亲甲状腺功能和儿童ADHD数据已知的母子对:INMA(N=1073,西班牙)、R代(N=3812,荷兰)和ALSPAC(N=2784,英国)。排除标准是多胎妊娠、生殖治疗、使用影响甲状腺的药物和预先存在的甲状腺疾病。研究人员使用Logistic回归模型来研究母体甲状腺功能与主要结局ADHD之间的关联,研究人员通过DSM-IV标准由父母和/或教师在中位儿童年龄为4.5至7.6岁时进行评估,以及与次要结局-ADHD症状评分高于第90百分位数之间的关系。研究人员通过相互作用项和分层分析评估了孕龄和性别的效果修正作用。

总体而言,233名(3%)儿童符合ADHD标准。当连续分析时,FT4和TSH都不会与ADHD的高风险[分别有比值比(OR)和95%置信区间(CI)为1.1(1.0-1.3),P=0.060和OR为0.9,95%CI为0.9- 1.1,P=0.385]或症状得分高相关。当研究胎龄的效果修正时,但仅在妊娠早期较高的FT4与第90百分位以上的症状相关[对于FT4每增加1个SD的OR为1.2(95%CI为1.0-1.4),P=0.027]。然而,这些孕龄的差异效应并不一致。没有观察到按性别改变的显著效果。

由此可见,该研究没有发现孕妇甲状腺功能与儿童多动症之间存在关联的明确证据。 

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