摘要目的：探讨围产期相关因素与先天性甲状腺功能减低（甲减）症（CH）的关系。方法采用病例对照研究。选择2012年1月至2013年12月在福建省新生儿疾病筛查中心诊断为CH的新生儿125例为病例组，按1∶3比例随机选择非CH的新生儿为对照组。采用单因素及二项分类logistic同归模型分析CH的围产期相关危险因素。结果单因素分析显示，病例组中母亲妊娠期高血压、妊娠期糖尿病、妊娠合并甲状腺疾病、高龄产妇的发生率高于对照组，差异有统计学意义（均P＜0.05）；病例组新生儿在女性、早产儿、过期儿、低出生体重儿、巨大儿、双胎及多胎、伴发其他出生缺陷和感染的发生率均高于对照组，差异有统计学意义（均P＜0.05）。多因素logistic回归分析显示，高龄产妇（OR＝2.518，95%CI：1.186～5.347）、妊娠期糖尿病（OR＝1.904，95%CI：1.190～3.045）、妊娠合并甲减（OR＝12.883，95%CI：2.055～80.751）或甲亢（OR＝30.797，95%CI：3.309～286.594）、早产儿（OR＝4.238，95%CI：1.269～14.155）、过期儿（OR＝12.799，95%CI：1.257～130.327）、低出生体重儿（OR＝3.505，95%CI：1.059～11.601）、巨大儿（OR＝3.733，95%CI：1.415～9.851）、双胎及多胎（OR＝5.493，95%CI：1.701～17.735）、伴发其他出生缺陷（OR＝3.665，95%CI：1.604～8.371）和胎儿窘迫（OR＝3.130，95%CI：1.317～7.440）为新生儿CH的高危因素（均P＜0.05）。结论新生儿CH与母亲孕龄、妊娠期糖尿病、妊娠合并甲状腺疾病以及新生儿出生体重、胎龄、胎数、胎儿窘迫、伴发其他出生缺陷等有一定关系，应加强围孕期保健，减少高危因素，降低CH发病率。

abstractsObjective To understand the relationship between perinatal factors and congenital hypothyroidism(CH)and provide scientific evidence for the prevention of CH. Methods A case-control study was conducted among 125 neonates with CH (case group) and 375 neonates without CH(control group)in Fujian Neonatal Screening Center from January in 2012 to December in 2013. Univariate and multivariate logistic regression analysis were performed to identify the risk factors to CH during perinatal period. Results Univariate logistic regression analysis indicated that compared with control group,gestational hypertension,gestational diabetes mellitus,gestational thyroid disease and older age of mother were the risk factors to CH,the difference was statistically significant (P<0.05) and the risk of CH was higher in female babies,preterm babies,post-term babies low birth weight babies,macrosomia,twins,babies with birth defects and infection in cases group than those in control group,the difference was statistically significant (P<0.05). Multivariate logistic analysis showed that older age of mother(OR=2.518,95%CI:1.186-5.347), gestational diabetes mellitus(OR=1.904,95%CI:1.190-3.045),gestational hypothyroidism or&nbsp;hyperthyroidism(OR=12.883 and 30.797,95%CI:2.055-80.751 and 3.309-286.594),preterm birth (OR=4.238,95%CI:1.269-14.155),and post-term birth(OR=12.799,95%CI:1.257-130.327),low birth weight(OR=3.505,95%CI:1.059-11.601),macrosomia(OR=3.733,95%CI:1.415-9.851), twin or multiparous delivery(OR=5.493,95%CI:1.701-17.735),birth defects(OR=3.665,95%CI:1.604-8.371)and fetal distress(OR=3.130,95%CI:1.317-7.440)were the high risk factors to CH (P<0.05). Conclusion CH was correlated with mother’s age,gestational diabetes,gestational thyroid disease as well as neonate’s birth weight and gestational age,foetus number,fetal distress and other complicated birth defects at certain degree. More attention should be paid to perinatal care to reduce risk factors and the incidence of CH.