早产儿促甲状腺素轻度增高与体格及神经心理发育关联性探讨

doi:10.20274/j.cnki.issn.2025.04.008

Abstract

Abstract:

To investigate the association between mildly elevated thyroid-stimulating hormone (TSH) levels during the first two weeks of life and physical/neuropsychological development in preterm infants. Methods A total of 102 preterm infants admitted to Sanming First Hospital between March 2021 and March 2023 were enrolled. The cohort comprised 52 infants with mild TSH elevation (observation group) and 50 infants with normal TSH levels (control group). Amplitude-integrated electroencephalography (aEEG) was performed on postnatal day 8. The differences in physical development at corrected age (CA) of 12 months and neuropsychological development at CA of 24 months were evaluated. The neuropsychological development was assessed using the Child Development Behavior Psychological Scale, and developmental quotient ≥85 was defined as normal. Results The aEEG monitoring on postnatal day 8 revealed that formation of sleep-wake cycle in the observation group was 26.9%(14/52), lower than that of the control group(46.0%, 23/50)(P<0.05).No differences existed in aEEG continuity or voltage parameters (maximum/minimum voltage) between the two groups (P>0.05).At CA of 12 months, the observation group demonstrated significantly smaller body length than the control group [(71.7±2.1) cm vs. (73.9±2.3) cm; P<0.001], while body weight and head circumference showed no significant differences (P>0.05).At CA of 24 months, the development quotient(DQ) of the observation group was lower that that of the control group in fine motor (90.0±2.7 vs. 91.6±1.6), language (89.0±2.7 vs. 90.0±1.6), and social behavior (91.0±1.7 vs. 91.8±1.8) (P<0.05). The DQ in gross motor and adaptive abilities showed no statistical differences between the two groups (P>0.05). Conclusion Mildly elevated TSH levels in preterm infants within 2 weeks after birth are associated with the formation of sleep-wake cycles, physical growth, and neuropsychological development, necessitating monitoring and management.

Key words: Preterm infants, Thyroid-stimulating hormone, Neuropsychological, Physical, Development

CLC Number:

R722.6

Enhuan WEI, Wei CHEN, Wanrong CHEN, Yunzhen DENG, Hui YANG. Exploration of the correlation between mild elevation of thyroid-stimulating hormone and physical and neuropsychological development in preterm infants[J]. Chinese Pediatrics of Integrated Traditional and Western Medicine, 2025, 17(4): 320-323.

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References 16

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项目	观察组（n=52）	对照组（n=50）
胎龄（x±s，周）	32.15±2.16	32.36±1.98
出生体质量（x±s，ｇ）	1 892.12±236.25	1 899.26±251.32
身长（x±s，cm）	43.18±1.29	43.26±1.81
头围（x±s，cm）	30.56±2.21	30.76±2.50
女性	23(44.23)	21(42.00)
顺产	47(90.38)	46(92.00)
病情危重	41(78.85）	38(76.00）
合并症
新生儿感染	31(59.62)	32(64.00)
新生儿窒息	8(15.38)	7(14.00)
新生儿肺透明膜病	23(44.23)	21(42.00)
支气管肺发育不良	5(9.62)	4(8.00)
胆汁淤积症	4(7.69)	3(6.00)
新生儿坏死性小肠结肠炎	2(3.85)	1(2.00)

组别	n	连续性脑电图[n(%)]	睡眠-觉醒周期[n(%)]	高电压（x±s，μV）	低电压（x±s，μV）
对照组	50	18(36.0)	23(46.0)	13.5±2.6	5.3±1.4
观察组	52	22(42.3)	14(26.9)	12.9±2.2	5.5±1.1
χ²/t值		0.43	4.01	-1.28	0.80
P值		0.514	0.045	0.203	0.425

组别	n	身高（cm）	体质量（kg）	头围(cm)
对照组	50	73.9±2.3	9.3±1.3	45.2±1.5
观察组	52	71.7±2.1	9.2±1.2	44.6±1.6
t值		-5.04	-0.32	-1.95
P值		<0.001	0.750	0.052

组别	n	大运动	精细动作	适应能力	语言	社交行为
对照组	50	89.5±2.6	91.6±1.6	90.8±2.7	90.0±1.6	91.8±1.8
观察组	52	89.0±2.1	90.0±2.7	90.5±2.1	89.0±2.7	91.0±1.7
t值		-1.07	-3.66	-0.62	-2.29	-2.23
P值		0.285	0.004	0.536	0.024	0.023

Exploration of the correlation between mild elevation of thyroid-stimulating hormone and physical and neuropsychological development in preterm infants

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