PDF(Pubmed)
Abstract：
BACKGROUND: Limited evidence exists regarding the association between gestational diabetes mellitus (GDM) and elevated levels of thyroid-stimulating hormone (TSH) in newborns. Therefore, this study aimed to investigate the potential risk of elevated TSH levels in infants exposed to maternal GDM, considering the type and number of abnormal values obtained from the 75-gram oral glucose tolerance test (OGTT).
METHODS: A population-based, prospective birth cohort study was conducted in Wuhan, China. The study included women who underwent GDM screening using a 75-g OGTT. Neonatal TSH levels were measured via a time-resolved immunofluorescence assay. We estimated and stratified the overall risk (adjusted Risk Ratio [RR]) of elevated TSH levels (defined as TSH > 10 mIU/L or > 20 mIU/L) in offspring based on the type and number of abnormal OGTT values.
RESULTS: Out of 15,236 eligible mother-offspring pairs, 11.5% (1,753) of mothers were diagnosed with GDM. Offspring born to women diagnosed with GDM demonstrated a statistically significant elevation in TSH levels when compared to offspring of non-GDM mothers, with a mean difference of 0.20 [95% CI: 0.04-0.36]. The incidence of elevated TSH levels (TSH > 10 mIU/L) in offspring of non-GDM women was 6.3 per 1,000 live births. Newborns exposed to mothers with three abnormal OGTT values displayed an almost five-fold increased risk of elevated TSH levels (adjusted RR 4.77 [95% CI 1.64-13.96]). Maternal fasting blood glucose was independently and positively correlated with neonatal TSH levels and elevated TSH status (TSH > 20 mIU/L).
CONCLUSIONS: For newborns of women with GDM, personalized risk assessment for elevated TSH levels can be predicated on the type and number of abnormal OGTT values. Furthermore, fasting blood glucose emerges as a critical predictive marker for elevated neonatal TSH status.
METHODS: A population-based, prospective birth cohort study was conducted in Wuhan, China. The study included women who underwent GDM screening using a 75-g OGTT. Neonatal TSH levels were measured via a time-resolved immunofluorescence assay. We estimated and stratified the overall risk (adjusted Risk Ratio [RR]) of elevated TSH levels (defined as TSH > 10 mIU/L or > 20 mIU/L) in offspring based on the type and number of abnormal OGTT values.
RESULTS: Out of 15,236 eligible mother-offspring pairs, 11.5% (1,753) of mothers were diagnosed with GDM. Offspring born to women diagnosed with GDM demonstrated a statistically significant elevation in TSH levels when compared to offspring of non-GDM mothers, with a mean difference of 0.20 [95% CI: 0.04-0.36]. The incidence of elevated TSH levels (TSH > 10 mIU/L) in offspring of non-GDM women was 6.3 per 1,000 live births. Newborns exposed to mothers with three abnormal OGTT values displayed an almost five-fold increased risk of elevated TSH levels (adjusted RR 4.77 [95% CI 1.64-13.96]). Maternal fasting blood glucose was independently and positively correlated with neonatal TSH levels and elevated TSH status (TSH > 20 mIU/L).
CONCLUSIONS: For newborns of women with GDM, personalized risk assessment for elevated TSH levels can be predicated on the type and number of abnormal OGTT values. Furthermore, fasting blood glucose emerges as a critical predictive marker for elevated neonatal TSH status.
摘要：
背景：关于妊娠糖尿病（GDM）与新生儿促甲状腺激素（TSH）水平升高之间的关系的证据有限。因此,这项研究旨在调查暴露于母体GDM的婴儿TSH水平升高的潜在风险。考虑从75克口服葡萄糖耐量试验（OGTT）获得的异常值的类型和数量。
方法：以人口为基础，前瞻性出生队列研究在武汉进行，中国。该研究包括使用75gOGTT进行GDM筛查的女性。通过时间分辨免疫荧光测定法测量新生儿TSH水平。我们根据异常OGTT值的类型和数量，对后代TSH水平升高（定义为TSH>10mIU/L或>20mIU/L）的总体风险（调整风险比[RR]）进行了估计和分层。
结果：在15,236对合格的母子中，11.5%(1,753)的母亲被诊断为GDM。与非GDM母亲的后代相比，诊断为GDM的女性的后代在TSH水平上有统计学意义的升高。平均差为0.20[95%CI：0.04-0.36]。非GDM妇女后代TSH水平升高（TSH>10mIU/L）的发生率为6.3/1,000活产。暴露于具有三个异常OGTT值的母亲的新生儿显示TSH水平升高的风险增加了近五倍(校正RR4.77[95%CI1.64-13.96])。产妇空腹血糖与新生儿TSH水平及TSH升高状态(TSH>20mIU/L)呈独立正相关。
结论：对于GDM女性的新生儿，TSH水平升高的个性化风险评估可以基于异常OGTT值的类型和数量来预测.此外，空腹血糖是新生儿TSH升高的关键预测指标.
方法：以人口为基础，前瞻性出生队列研究在武汉进行，中国。该研究包括使用75gOGTT进行GDM筛查的女性。通过时间分辨免疫荧光测定法测量新生儿TSH水平。我们根据异常OGTT值的类型和数量，对后代TSH水平升高（定义为TSH>10mIU/L或>20mIU/L）的总体风险（调整风险比[RR]）进行了估计和分层。
结果：在15,236对合格的母子中，11.5%(1,753)的母亲被诊断为GDM。与非GDM母亲的后代相比，诊断为GDM的女性的后代在TSH水平上有统计学意义的升高。平均差为0.20[95%CI：0.04-0.36]。非GDM妇女后代TSH水平升高（TSH>10mIU/L）的发生率为6.3/1,000活产。暴露于具有三个异常OGTT值的母亲的新生儿显示TSH水平升高的风险增加了近五倍(校正RR4.77[95%CI1.64-13.96])。产妇空腹血糖与新生儿TSH水平及TSH升高状态(TSH>20mIU/L)呈独立正相关。
结论：对于GDM女性的新生儿，TSH水平升高的个性化风险评估可以基于异常OGTT值的类型和数量来预测.此外，空腹血糖是新生儿TSH升高的关键预测指标.
