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Thyroid dysfunctions of prematurity and their impacts on neurodevelopmental outcome1)

  • Mi Lim Chung , Han Wok Yoo , Ki-Soo Kim , Byong Sop Lee , Soo-Young Pi , Gina Lim and Ellen Ai-Rhan Kim EMAIL logo
Published/Copyright: February 15, 2013
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 26 Issue 5-6

Abstract

Background: Thyroid dysfunction is very common and is associated with neurodevelopmental impairments in preterm infants.

Objectives: This study was conducted to determine the incidence and natural course of various thyroid dysfunctions and their impacts on neurodevelopmental outcomes among premature infants.

Methods: A total of 177 infants were enrolled who were born at <34 weeks or whose birth weight was <1500 g and who underwent repeat thyroid function tests. We analyzed how various thyroid dysfunctions affected neurodevelopmental outcomes at 18 months of corrected age.

Results: Thyroid dysfunction was noted in 88 infants. Hypothyroxinemia was observed in 23 infants, and their thyroid function was influenced by variable clinical factors. Free T4 levels were all normalized without thyroxine medication, and neurodevelopmental outcomes were not affected. In contrast, hyperthyrotropinemia was not associated with other clinical factors. Among 58 subjects who had hyperthyrotropinemia, only 31 infants showed normal thyroid-stimulating hormone (TSH) levels at follow-up tests. The remaining 27 infants had persistently high TSH levels, which significantly and poorly influenced the neurodevelopmental outcomes.

Conclusions: Thyroid dysfunction is common among preterm infants. With the exception of persistent hyperthyrotropinemia, it generally does not affect neurodevelopmental outcomes. However, the beneficial effects of thyroid hormone therapy in patients with persistent hyperthyrotropinemia merits further study.

Keywords: neurodevelopmental outcome; thyroid dysfunction; very low birth weight infants
Corresponding author: Ellen Ai-Rhan Kim, MD, Division of Neonatology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, 86, Asan Byung Won Gil, Song-pa Gu, Busan, Seoul 138-736, Cheonju, Phone: +82 2 3010 3390, Fax: +81 2 3010 6978

Conflict of interest statement

Disclosure: The authors have no financial relationships relevant to this article.

Competing interest: None to declare.

  1. 1)

    This study was approved by the institutional review board of Asan Medical Center, which obtained official certification from the WHO-affiliated Forum for Ethical Review Committees in Asia and the Western Pacific.

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Received: 2012-10-17
Accepted: 2012-12-22
Published Online: 2013-02-15
Published in Print: 2013-05-01

©2013 by Walter de Gruyter Berlin Boston

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  43. Meetings
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https://doi.org/10.1515/jpem-2012-0332
Keywords for this article
neurodevelopmental outcome; thyroid dysfunction; very low birth weight infants

Articles in the same Issue

  1. Masthead
  2. Masthead
  3. Editorial
  4. Success has many fathers, failure is orphan
  5. Review Article
  6. Normosmic idiopathic hypogonadotropic hypogonadism: update on the genetic background and future challenges
  7. Original Articles
  8. Temporary brittle bone disease: association with intracranial bleeding
  9. Asymmetric dimethylarginine (ADMA) and L-arginine levels in children with glycogen storage disease type I
  10. Application of liquid chromatography-tandem mass spectrometry in the diagnosis and follow-up of maple syrup urine disease in a Chinese population
  11. The role of uncoupling protein 2 and 3 genes polymorphism and energy expenditure in obese Indonesian children
  12. Thyroid dysfunctions of prematurity and their impacts on neurodevelopmental outcome1)
  13. Frequency of the E23K polymorphism of the KCNJ11 gene in children born small for gestational age and its influence on auxological and metabolic parameters in the prepubertal period
  14. Reference intervals for serum thyroid hormones in preterm hospitalized infants1)
  15. The clinical and biochemical presentation of vitamin D deficiency and insufficiency in children and adolescents
  16. A risk score for identifying overweight adolescents with dysglycemia in primary care settings1)
  17. Thyroid function and morphology in overweight and obese children and adolescents in a Chinese population
  18. Propionic acidaemia: demographic characteristics and complicationsa
  19. Negative correlation between serum IL-6 level and cardiorespiratory fitness in 10- to 11-year-old boys with increased BMI
  20. Penile length and genital anomalies in Egyptian male newborns: epidemiology and influence of endocrine disruptors
  21. Efficacy of vitamin D loading doses on serum 25-hydroxy vitamin D levels in school going adolescents: an open label non-randomized prospective trial
  22. Characteristics of infants admitted with hypoglycemia to a neonatal unit
  23. Increasing thyroid-stimulating hormone is associated with impaired glucose metabolism in euthyroid obese children and adolescents
  24. The role of FTO genotype on eating behavior in obese Sardinian children and adolescents
  25. Prevalence of multiple forms of autoimmunity in Egyptian patients with Turner syndrome: relation to karyotype
  26. A novel DAX-1 mutation presented with precocious puberty and hypogonadotropic hypogonadism in different members of a large pedigree
  27. Patient Reports
  28. Pseudohypoparathyroidism type Ia: a novel GNAS mutation in a Brazilian boy presenting with an early primary hypothyroidism
  29. Diabetic ketoacidosis with cerebral hemorrhage and alpha coma in an adolescent female
  30. A novel mutation in thyrotropin (thyroid-stimulating hormone) gene in congenital hypothyroidism
  31. Citric acid as the last therapeutic approach in an acute life-threatening metabolic decompensation of propionic acidaemia
  32. A case of autosomal dominant osteopetrosis type II with a novel TCIRG1 gene mutation
  33. The interpretation of color – an endocrine cause of skin discoloration mimicking cyanosis
  34. Novel heterozygous thyrotropin receptor mutation presenting with neonatal hyperthyrotropinaemia, mild thyroid hypoplasia and absent uptake on radioisotope scan
  35. Turner Syndrome and apparent absent uterus: a case report and review of the literature
  36. 10.1515/jpem-2012-0133
  37. Vaginal bleeding in a 4-month-old preterm girl: extreme minipuberty mimicking central precocious puberty
  38. A rare case of isolated Cushing syndrome in a 3-month-old boy
  39. Letters to the Editors
  40. Gynecomastia in puberty is usually asymptomatic and regresses spontaneously
  41. Is endometriosis ultimately the end result of the interplay between interferon-γ (IFN-γ) and the HOXA10 gene network?
  42. Does treatment with L-selenomethionine reduce thyroid volume in euthyroid children with autoimmune thyroiditis?
  43. Meetings
  44. Meetings Calendar
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