| Objective:Transient hypothyroidism in neonates is a common complication of premature infants,and in recent years,due to the increase in the survival rate of premature infants and low birth weight infants,the incidence has also increased.The incidence of hypothyroidism is higher in very low/extremely low birth weight infants(VLBW/ELBW).Although it is mostly temporary,mild hypothyroidism early in life can affect the child’s development and even cause serious sequelae.The objective of this study was to analyze the risk factors for transient hypothyroidism in very low/extremely low birth weight infants in some areas of Anhui Province,so as to reduce the effect of hypothyroidism on VLBW/ELBW children.Methods:A total of 167 VLBW/ELBW infants treated in the Department of Intensive Neonatology of the Second Affiliated Hospital of Anhui Medical University from February 2015 to May 2022 were included in the sample,which were divided into hypothyroidism group(n=47)and non-hypothyroidism group(n=120)according to their clinical outcomes.The clinical data of the two groups were compared.The correlation between transient hypothyroidism and gestational age,birth weight,birth score,etc.,and the risk factors of hypothyroidism were analyzed by univariate analysis and multivariate logistic regression.The predictive value of subjects was assessed by plotting their operating characteristic curves(ROC curves).Results:1.General information: There were 167 children with VLBW/ELBW who met the inclusion criteria,including 75 males(45%)and 92 females(55%),with a male-to-female ratio of 1:1.22.Among them,the minimum gestational age is 25 weeks,the maximum is 34 weeks,and the average is 29 weeks.The minimum birth weight was 620 g,the maximum was 1490 g,the median was 1300 g.44.9% of the children had birth asphyxia,and the average hospital stay was 41 days.2.Univariate analysis showed that gestational age,birth weight,1-minute Apgar score,gestational hypertension,delivery mode,neonatal respiratory distress syndrome(NRDS),etc.were associated with hypothyroidism of VLBW/ELBW(P<0.05).(1)Individual factors at birth: the difference between groups between gestational age and hypothyroidism was statistically significant(P<0.001,χ2=22.276),and the difference between birth weight and hypothyroidism was statistically significant(P=0.001,χ~2=14.301).(2)In terms of maternal factors: the difference between groups between hypertension during pregnancy and hypothyroidism was statistically significant(P<0.001,χ2=16.45),and the mode of delivery was the risk factor of hypothyroidism(P=0.017,χ2=5.70),while hypothyroidism during pregnancy was not a high-risk factor for hypothyroidism(P=0.802,χ2=0.063).(3)In terms of birth combination: the difference between the one-minute Apgar score and hypothyroidism was statistically significant(P<0.01,χ2=13.422),and NRDS was the risk factor for hypothyroidism(P <0.01,χ2=7.548)。3.Multivariate logistic regression results showed that gestational age,1-minute Apgar score,and maternal hypertension during pregnancy were independent risk factors for hypothyroidism in VLBW/ELBW,P<0.05.The ROC curve was plotted,and the area under the three curves was 0.762,0.660 and 0.647,respectively,and when the three indexes were jointly detected,the maximum area under the curve was 0.812,the sensitivity was 72.0%,and the specificity was 84.0%.Conclusion:Gestational age,1-minute apgar score,and maternal hypertension during pregnancy were independent risk factors for VLBW/ELBW hypothyroidism.When the three indexes were combined to detect it,the hypothyroidism of VLBE/ELBW was well predicted. |
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