Thyroid Function in 509 Premature Newborns Below 31 Weeks of Gestational Age : Evaluation and Follow-up
Campos-Martorell, Ariadna (Hospital Universitari Vall d'Hebron)
Montaner Ramón, Alicia (Hospital Universitari Vall d'Hebron)
Narváez Barros, Karla (Hospital del Mar (Barcelona, Catalunya))
Marin Soria, Jose Luis (Hospital Clínic i Provincial de Barcelona)
López Galera, Rosa Maria (Hospital Clínic i Provincial de Barcelona)
Yeste Fernández, Diego (Hospital Universitari Vall d'Hebron)
Clemente, Maria (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	Preterm and low birth weight (LBW) neonates may present with thyroid dysfunction during a critical period for neurodevelopment. These alterations can be missed on routine congenital hypothyroidism (CH) screening which only measures thyroid stimulating hormone (TSH). The objective of this study was to evaluate a protocol for thyroid function screening (TFS) six years after national implementation. Serum TSH and free thyroxine (fT4) were measured during the second week of life in neonates below 31 weeks. Patients with abnormal TFS (fT4 <0. 8 ng/dL and/or TSH >5 mU/L) were followed up with repeated tests until normal levels were reported. Patients who were still on levothyroxine (LT4) at three years of age were re-evaluated. Five-hundred and nine neonates were included. Thyroid dysfunction was detected in 170 neonates (33%); CH n=20 (3. 9%) including typical CH n=1; delayed TSH elevation CH n=19; hypothyroxinemia of prematurity (HOP) n=15 (2. 9%); and transient hyperthyrotropinemia n=135 (26. 5%). Twenty-one neonates (4. 1%) were treated (20 for CH and 1 for HOP). At 3-year follow-up only three patients were diagnosed with permanent CH and still need treatment. LBW infants tended to have TSH levels higher than those with adequate weight. This protocol was able to detect thyroid dysfunction in preterm neonates who were not identified by the current program based on TSH determination in whole-blood. This thyroid dysfunction seems to resolve spontaneously in a few months in the great majority of neonates, but in some cases LT4 could be needed. There is a critical need for specific guidelines regarding the follow-up and re-evaluation of transient CH in preterm neonates.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Congenital hypothyroidism ; Delayed TSH rise ; Hypothyroxinemia of prematurity ; Low birth weight ; Preterm newborn
Published in:	Journal of Clinical Research in Pediatric Endocrinology, Vol. 14 (december 2022) , p. 453-462, ISSN 1308-5735

DOI: 10.4274/jcrpe.galenos.2022.2022-2-1
PMID: 35860376

10 p, 393.1 KB

The record appears in these collections:
Articles > Research articles
Articles > Published articles