Thyroid Function in 509 Premature Newborns Below 31 Weeks of Gestational Age

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 t...

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Autores: Campos-Martorell, Ariadna|||0000-0002-8134-4934, Montaner Ramón, Alicia|||0000-0002-7327-0066, Narváez Barros, Karla|||0000-0003-1455-527X, Marin Soria, Jose Luis|||0000-0003-3953-4272, López Galera, Rosa Maria|||0000-0001-5072-1429, Yeste Fernández, Diego|||0000-0002-6620-6525, Clemente, Maria|||0000-0002-3721-5043
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:281779
Acceso en línea:https://ddd.uab.cat/record/281779
https://dx.doi.org/urn:doi:10.4274/jcrpe.galenos.2022.2022-2-1
Access Level:acceso abierto
Palabra clave:Congenital hypothyroidism
Delayed TSH rise
Hypothyroxinemia of prematurity
Low birth weight
Preterm newborn
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spelling Thyroid Function in 509 Premature Newborns Below 31 Weeks of Gestational AgeEvaluation and Follow-upCampos-Martorell, Ariadna|||0000-0002-8134-4934Montaner Ramón, Alicia|||0000-0002-7327-0066Narváez Barros, Karla|||0000-0003-1455-527XMarin Soria, Jose Luis|||0000-0003-3953-4272López Galera, Rosa Maria|||0000-0001-5072-1429Yeste Fernández, Diego|||0000-0002-6620-6525Clemente, Maria|||0000-0002-3721-5043Congenital hypothyroidismDelayed TSH riseHypothyroxinemia of prematurityLow birth weightPreterm newbornPreterm 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.Universitat Autònoma de Barcelona 22022-01-0120222022-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/281779https://dx.doi.org/urn:doi:10.4274/jcrpe.galenos.2022.2022-2-1reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest 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.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2817792026-06-06T12:50:31Z
dc.title.none.fl_str_mv Thyroid Function in 509 Premature Newborns Below 31 Weeks of Gestational Age
Evaluation and Follow-up
title Thyroid Function in 509 Premature Newborns Below 31 Weeks of Gestational Age
spellingShingle Thyroid Function in 509 Premature Newborns Below 31 Weeks of Gestational Age
Campos-Martorell, Ariadna|||0000-0002-8134-4934
Congenital hypothyroidism
Delayed TSH rise
Hypothyroxinemia of prematurity
Low birth weight
Preterm newborn
title_short Thyroid Function in 509 Premature Newborns Below 31 Weeks of Gestational Age
title_full Thyroid Function in 509 Premature Newborns Below 31 Weeks of Gestational Age
title_fullStr Thyroid Function in 509 Premature Newborns Below 31 Weeks of Gestational Age
title_full_unstemmed Thyroid Function in 509 Premature Newborns Below 31 Weeks of Gestational Age
title_sort Thyroid Function in 509 Premature Newborns Below 31 Weeks of Gestational Age
dc.creator.none.fl_str_mv Campos-Martorell, Ariadna|||0000-0002-8134-4934
Montaner Ramón, Alicia|||0000-0002-7327-0066
Narváez Barros, Karla|||0000-0003-1455-527X
Marin Soria, Jose Luis|||0000-0003-3953-4272
López Galera, Rosa Maria|||0000-0001-5072-1429
Yeste Fernández, Diego|||0000-0002-6620-6525
Clemente, Maria|||0000-0002-3721-5043
author Campos-Martorell, Ariadna|||0000-0002-8134-4934
author_facet Campos-Martorell, Ariadna|||0000-0002-8134-4934
Montaner Ramón, Alicia|||0000-0002-7327-0066
Narváez Barros, Karla|||0000-0003-1455-527X
Marin Soria, Jose Luis|||0000-0003-3953-4272
López Galera, Rosa Maria|||0000-0001-5072-1429
Yeste Fernández, Diego|||0000-0002-6620-6525
Clemente, Maria|||0000-0002-3721-5043
author_role author
author2 Montaner Ramón, Alicia|||0000-0002-7327-0066
Narváez Barros, Karla|||0000-0003-1455-527X
Marin Soria, Jose Luis|||0000-0003-3953-4272
López Galera, Rosa Maria|||0000-0001-5072-1429
Yeste Fernández, Diego|||0000-0002-6620-6525
Clemente, Maria|||0000-0002-3721-5043
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Congenital hypothyroidism
Delayed TSH rise
Hypothyroxinemia of prematurity
Low birth weight
Preterm newborn
topic Congenital hypothyroidism
Delayed TSH rise
Hypothyroxinemia of prematurity
Low birth weight
Preterm newborn
description 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.
publishDate 2022
dc.date.none.fl_str_mv 2
2022-01-01
2022
2022-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/281779
https://dx.doi.org/urn:doi:10.4274/jcrpe.galenos.2022.2022-2-1
url https://ddd.uab.cat/record/281779
https://dx.doi.org/urn:doi:10.4274/jcrpe.galenos.2022.2022-2-1
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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