ISSN: 1308-5727 | E-ISSN: 1308-5735
Volume : Issue : Year : 2022
Forms

Abstracting & Indexing
Turkish Society for Pediatric Endocrinology and Diabetes
Thyroid Function in 509 Premature Newborns Below 31 Weeks of Gestational Age: Evaluation and Follow-up [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. Ahead of Print: JCRPE-65265 | DOI: 10.4274/jcrpe.galenos.2022.2022-2-1

Thyroid Function in 509 Premature Newborns Below 31 Weeks of Gestational Age: Evaluation and Follow-up

Ariadna Campos-martorell1, Alicia Montaner Ramon2, Karla Narváez Barros3, Jose Luis Marin Soria4, Rosa Maria López Galera4, Diego Yeste Fernández5, María Clemente León6
1Pediatric Endocrinology Unit. Vall d’Hebron University Hospital. Barcelona, Spain. Autonomous University of Barcelona. Barcelona, Spain
2Neonatal Unit. Vall d’Hebron University Hospital. Barcelona, Spain
3Pediatric Endocrinology Unit. Hospital del Mar. Barcelona, Spain
4Neonatal Screening Program of Catalonia. Inborn Errors Metabolism Unit Biochemistry and Molecular Genetics Department Center for Biomedical Diagnosis (CDB) Hospital Clinic. Barcelona. Spain School of Medicine. University of Barcelona. Spain
5Pediatric Endocrinology Unit. Vall d’Hebron University Hospital. Barcelona, Spain. Vall d’Hebron Research Institute. Paediatric Endocrinology. Vall d’Hebron University Hospital. Barcelona, Spain. Autonomous University of Barcelona. Barcelona, Spain
6Pediatric Endocrinology Unit. Vall d’Hebron University Hospital. Barcelona, Spain. Vall d’Hebron Research Institute. Paedriatic Endocrinology. Vall d’Hebron University Hospital. Barcelona, Spain. Autonomous University of Barcelona. Barcelona, Spain

INTRODUCTION: Preterm and low birth weight (LBW) neonates could present thyroid dysfunction during a critical period for neurodevelopment. These alterations can be missed in the congenital hypothyroidism screening which only measures TSH. The objective of this study was to evaluate a protocol for thyroid function screening (TFS) 6 years after its implementation.
METHODS: Serum TSH and free thyroxine (FT4) were performed during the second week of life in neonates below 31 weeks. Patients with abnormal TFS (FT4<0.8ng/dL and/or TSH>5mU/L) were followed up with repeated tests until normal levels were reported. Patients who were still on levothyroxine at 3 years of age were re-evaluated.
RESULTS: 509 neonates were included. Thyroid dysfunction was detected in 170 neonates (33%); congenital hypothyroidism (CH): 20 (3.9%) [typical CH: 1; delayed TSH CH: 19]; hypothyroxinemia of prematurity (HOP): 15 (2.9%); and transient hyperthyrotropinemia: 135 (26.5%). Twenty-one neonates (4.1%) were treated (20 for CH and 1 for HOP). At 3-year follow-up only 3 patients were diagnosed with permanent CH and still need treatment. LBW presented TSH levels higher than those with adequate weight.
DISCUSSION AND CONCLUSION: 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 levothyroxine could be needed. There is a critical need for specific guidelines regarding the follow-up and reevaluation of transient CH in preterm neonates.

Keywords: preterm newborn, low birth weight, congenital hypothyroidism, hypothyroxinemia of prematurity, delayed TSH rise



Corresponding Author: Ariadna Campos-martorell, Spain
Manuscript Language: English
LookUs & Online Makale