Analysis of Risk Factors and Screening Results of Neonatal Congenital Hypothyroidism in a Tertiary Care Center of Southern China

OBJECTIVE: To explore the risk factors for neonatal congenital hypothyroidism (CH) and the influencing factors of false-positive results in CH screening. METHODS: In this study, 255 neonatal patients with CH who completed the screening and further diagnosis and 366 neonates with positive CH screening results and normal thyroid function were selected as the case group. 246 healthy neonates with normal thyroid function were selected as the control group. Gestational age, birth-weight, maternal age, small for gestational age (SGA), perinatal factors (gestational thyroid dysfunction, gestational diabetes mellitus, etc.) were used as influencing factors, using χ(2) tests were performed for comparison. The statistically significant variables were analyzed with Logistic multiple regression models, and the difference was considered statistically significant (P<0.05). RESULTS: There were statistical differences in the SGA, maternal gestational diabetes mellitus, thyroid disease, and the proportion using assisted reproduction technology among the case group, false-positive screening group, and control group (χ(2) was 11.943, 6.857, 6.999, 9.732, respectively, P < 0.05). The results of multivariate logistic regression analysis showed that the gestational thyroid disease (OR = 8.452, 95% CI:1.051–67.982), gestational diabetes mellitus (OR = 2.654, 95% CI:1.051–6.706), and assisted reproduction (OR = 0.194, 95% CI:0.041–0.911) were the influencing factors for neonatal CH, and the difference was statistically significant (P < 0.05). The SGA (OR = 2.556, 95% CI:1.027–6.361), gestational thyroid disease (OR = 7.801, 95% CI:1.03–59.057), gestational diabetes mellitus (OR = 2.731, 95% CI:1.18–6.322), and assisted reproduction (OR = 0.28, 95% CI:0.102–0.765) were the influencing factors of the false-positive screening results of neonatal CH. The difference was statistically significant (P < 0.05). CONCLUSION: Neonatal CH and positive screening results are influenced by assisted reproduction, gestational thyroid dysfunction, gestational diabetes mellitus, and SGA.