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首页> 外文期刊>Sao Paulo Medical Journal >Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases
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Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers' diseases

机译：脐带血中促甲状腺激素水平不受非甲状腺母亲疾病的影响

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CONTEXT: Screening programs not only offer the opportunity to trace and treat almost all cases of congenital hypothyroidism but also mean large savings to the health system. However, carefully planned strategies are necessary to extend their benefits and reduce costs. OBJECTIVE: To determine the possible influence of maternal diseases that affect maternal-fetal placenta dynamics on primary thyroid stimulating hormone (TSH) screening for congenital hypothyroidism. DESIGN: Prospective non-randomized clinical trial with at least 3 months of follow-up. SETTING: A public university referral center [CAISM/Hospital das Clínicas, Faculty of Medicine, University of Campinas, Campinas, SP]. PARTICIPANTS: 415 neonates divided into 5 groups: eighty-three infants born from cardiac mothers; 98 from mothers that had toxemia; 54 of the mothers had diabetes mellitus; 40 were HIV positive and 140 had no diseases. INTERVENTION: All newborns had cord blood samples collected on filter paper at birth. MAIN MEASUREMENTS: TSH was measured from dried blood spots using a homemade immunofluorescence assay (sensitivity in dried blood spots = 0.1 mU/L). RESULTS: There was no significant difference in the mean TSH levels among the 5 groups. Moreover, TSH levels were around 5 mU/L in 48% of the newborns, indicating that our region is severely deficient in iodine. CONCLUSIONS: Our results indicate that primary TSH screening programs using cord blood are not affected by maternal diseases. We suggest that, besides its technical advantages over heel punctures with T4 primary approaches, neonatal screening using primary cord blood TSH may also be used as a monitoring tool for evaluation and control of iodine deficiency disorders (IDD).
机译：背景：筛查程序不仅为追踪和治疗几乎所有先天性甲状腺功能减退症提供了机会，而且还意味着可以为卫生系统节省大量资金。但是，必须精心计划策略以扩大其收益并降低成本。目的：确定影响母婴胎盘动力学的母体疾病对原发性甲状腺功能减退症的原发性甲状腺刺激激素（TSH）筛查的可能影响。设计：前瞻性非随机临床试验，至少随访3个月。地点：公立大学转诊中心[CAISM / Hospital dasClínicas，医学部，坎皮纳斯大学，坎皮纳斯，SP]。参加者：415例新生儿，分为5组：八十三名婴儿从心脏母亲那里出生; 98名患有毒血症的母亲; 54名母亲患有糖尿病; 40例艾滋病毒呈阳性，140例无疾病。干预：所有新生儿出生时均在滤纸上收集了脐带血样本。主要测量：使用自制的免疫荧光测定法从干血斑中测量TSH（干血斑中的灵敏度= 0.1 mU / L）。结果：5组之间的平均TSH水平无显着差异。此外，在48％的新生儿中，TSH水平约为5 mU / L，这表明我们地区的碘严重缺乏。结论：我们的结果表明，使用脐带血的初次TSH筛查程序不受母体疾病的影响。我们建议，除了通过T4初级入路进行足跟穿刺的技术优势外，使用初级脐带血TSH进行的新生儿筛查也可以用作监测和评估碘缺乏症（IDD）的监测工具。

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