孕期母体 TPOAb 呈阳性可能与学龄前儿童的情绪和行为问题有关

Association of maternal thyroid peroxidase antibody exposure with children's emotional and behavioral problems

母体甲状腺过氧化物酶抗体暴露与儿童情绪和行为问题的关联

Authors: Penggui Wu, Mengting Yang, Yuzhu Teng, Jiajun Ouyang, Wenjin Cai, Juan Tong, Guopeng Gao, Xiaoyan Wu, Yan Han, Shuangqin Yan, Fangbiao Tao, Kun Huang

Source: European Thyroid Journal

PMID: 40198715

DOI: 10.1530/ETJ-24-0302

Abstract

Objective: Maternal thyroid peroxidase antibody (TPOAb) positivity has been associated with a variety of pregnancy complications and has potential neuropsychological developmental implications for the offspring. The aim of our study was to explore the effect of maternal TPOAb levels on emotional and behavioural problems in children.

Design: Cohort study Participants: Based on the Maanshan Birth Cohort in China, 2464 mother-infant pairs were included in this study.

Measurements: Repeated blood samples were collected from pregnant women and TPOAb and FT4 were measured retrospectively by electrochemiluminescence immunoassay (ECLIA). The Strengths and Difficulties Questionnaire (SDQ) was used to assess the emotional and behavioural problems of 4-year-old preschoolers.

Results: After adjusting for potential confounders, maternal TPOAb positivity during the third trimester of pregnancy was found to be associated with an elevated risk of conduct problems in girls, with an OR of 2.190 (95% CI: 1.137 - 4.219). Conversely, maternal TPOAb positivity in the first trimester was linked to a decreased incidence of prosocial behavior in boys, with an OR of 0.451 (95% CI: 0.237 - 0.861).

Conclusions: Maternal TPOAb positivity during pregnancy may be associated with emotional and behavioral problems in preschool - aged children.

摘要

目的： 母体甲状腺过氧化物酶抗体（TPOAb）呈阳性与多种妊娠并发症相关，并且对子代的神经心理发育可能存在潜在影响。本研究旨在探究母体 TPOAb 水平对儿童情绪及行为问题的影响。
研究设计：队列研究
研究对象： 本研究基于中国马鞍山出生队列，纳入了 2464 对母婴。
测量方法： 对孕妇多次采集血样，通过电化学发光免疫分析法（ECLIA）回顾性检测甲状腺过氧化物酶抗体（TPOAb）和游离甲状腺素（FT4）水平。采用长处和困难问卷（SDQ）评估 4 岁学龄前儿童的情绪和行为问题。
研究结果： 在对潜在混杂因素进行校正后发现，妊娠晚期母体 TPOAb 呈阳性与女孩出现品行问题的风险升高相关，比值比（OR）为 2.190（95% 置信区间：1.137-4.219）。相反，妊娠早期母体 TPOAb 呈阳性与男孩亲社会行为发生率降低相关，比值比（OR）为 0.451（95% 置信区间：0.237-0.861） 。
研究结论： 孕期母体 TPOAb 呈阳性可能与学龄前儿童的情绪和行为问题有关。
关键词： 甲状腺过氧化物酶抗体；甲状腺激素；甲状腺激素变化轨迹；情绪和行为问题；妊娠；学龄前儿童