This study aimed to explore the relationship of maternal thyroid function and thyroid resistance parameters with neonatal thyroid-stimulating hormone (TSH).

This work was a longitudinal study. Singleton pregnant women without a history of thyroid disorders were recruited in their first prenatal visit from October 2018 to June 2020. Maternal thyroid markers including TSH, free triiodothyronine (FT3), free thyroxine (FT4), and neonatal TSH were tested in the clinical laboratory of the hospital by electrochemiluminescence immunoassay. Thyroid resistance indices including Thyroid Feedback Quantile-based Index (TFQI), TSH index (TSHI), and thyrotroph T4 resistance index (TT4RI) were estimated in accordance with maternal FT4 and TSH levels. Multivariable linear and logistic regression was applied to explore the associations of maternal thyroid indices with infantile TSH level.

A total of 3,210 mothers and 2,991 newborns with valid TSH data were included for analysis. Multivariable linear regression indicated that maternal thyroid variables were significantly and positively associated with neonatal TSH levels with standardized coefficients of 0.085 for TSH, 0.102 for FT3, 0.100 for FT4, 0.076 for TSHI, 0.087 for TFQI, and 0.089 for TT4RI (all P < 0.001). Compared with the lowest quartile, the highest quartile of TSHI [odds ratio (OR) = 1.590, 95% CI: 0.928–2.724; P_trend = 0.025], TFQI (OR = 1.746, 95% CI: 1.005–3.034; P_trend = 0.016), and TT4RI (OR = 1.730, 95% CI: 1.021–2.934; P_trend = 0.030) were significantly associated with an increased risk of elevated neonatal TSH (>5 mIU/L) in a dose–response manner.

The longitudinal data demonstrated that maternal thyroid resistance indices and thyroid hormones in the first half of gestation were positively associated with neonatal TSH levels. The findings offered an additionally practical recommendation to improve the current screening algorithms for congenital hypothyroidism.

本研究旨在探讨母体甲状腺功能和甲状腺抵抗参数与新生儿促甲状腺激素（TSH）的关系。

这项工作是一项纵向研究。在 2018 年 10 月至 2020 年 6 月的第一次产前检查中招募了没有甲状腺疾病史的单胎孕妇。在临床实验室检测了包括 TSH、游离三碘甲状腺原氨酸 (FT3)、游离甲状腺素 (FT4) 和新生儿 TSH 在内的母体甲状腺标志物医院通过电化学发光免疫分析。根据母体 FT4 和 TSH 水平估计甲状腺抵抗指数，包括基于甲状腺反馈分位数的指数 (TFQI)、TSH 指数 (TSHI) 和促甲状腺激素 T4 抵抗指数 (TT4RI)。应用多变量线性和逻辑回归来探索母体甲状腺指数与婴儿 TSH 水平的关系。

共有 3,210 名母亲和 2,991 名具有有效 TSH 数据的新生儿被纳入分析。多变量线性回归表明，母体甲状腺变量与新生儿 TSH 水平呈显着正相关，TSH 的标准化系数为 0.085，FT3 的标准化系数为 0.102，FT4 的标准化系数为 0.100，TSHI 的标准化系数为 0.076，TFQI 的标准化系数为 0.087，TT4RI 的标准化系数为 0.089（均 P < 0.001 ）。与最低四分位数相比，最高四分位数 TSHI [优势比 (OR) = 1.590, 95% CI: 0.928–2.724; P_趋势= 0.025]、TFQI (OR = 1.746, 95% CI: 1.005–3.034; P_趋势= 0.016) 和 TT4RI (OR = 1.730, 95% CI: 1.021–2.934; P_趋势= 0.030) 与以剂量反应方式增加新生儿 TSH (>5 mIU/L) 升高的风险。

纵向数据表明，妊娠前半期母体甲状腺抵抗指数和甲状腺激素与新生儿TSH水平呈正相关。该研究结果为改进当前的先天性甲状腺功能减退症筛查算法提供了额外的实用建议。