目的分析先天性甲状腺功能减低症(CH)发病趋势及影响因素,为制定CH防治策略提供参考依据。方法分析2004-2018年北京市朝阳区CH发病率趋势,采用病例对照研究,选择确诊CH的105例新生儿为病例组,按1:4配比选择非CH的420例新生儿为对照组,采用单因素及多因素Logistic回归分析CH发病的影响因素。结果 15年来,CH发病率总体呈上升趋势,总体发病率为53.13/10万,发病率的年度平均增长率为6.66%;单因素分析结果显示,病例组新生儿早产、剖宫产、低出生体重及身长<50 cm的发生率高于对照组,差异有统计学意义(P <0.05);多因素Logistic回归分析显示,剖宫产和早产为CH发病的危险因素(P <0.05),不同出生体重、身长的新生儿CH发病率差异无统计学意义。结论 15年来,北京市朝阳区CH发病率总体呈上升趋势,剖宫产、早产与新生儿CH有一定关系。加强孕期保健和管理,减少早产儿的出生,对于降低CH发病率,提高出生人口素质有着积极的意义。

Objective To investigate the epidemiologic characteristics and risk factors for congenital hypothyroidism(CH) in Chaoyang District of Beijing,and to provide evidence for the prevention of CH.Methods The incidence trend of CH in Chaoyang District from 2004 to 2018 were analyzed.A total of 105 neonates with CH were selected as case group and 420 non-CH neonates as control group by 1:4 matched case-control study,univariate and multivariate logistic regression were used to analyze the influencing factors of CH.Results In the past 15 years,the incidence of CH has been increasing,with an overall incidence of 53.13/100 000 and an annual average growth rate of 6.66%.Univariate logistic regression analysis indicated that premature delivery,cesarean section,low birth weight and body length <50 cm were the risk factors to CH,the difference was statistically significant(P <0.05).Multivariate logistic analysis showed that cesarean section and preterm delivery were the high risk factors to CH(P <0.05),there was no significant difference of CH among newborns with different birth weights and body lengths.Conclusion The prevalence rate of CH shows upward trend in Chaoyang District of Beijing,cesarean section and premature were the risk factors affecting the incidence of CH.It is crucial to prevent preterm infants delivery which has the positive significance to improve the population quality.