Home Thyroid function in late preterm infants in relation to mode of delivery and respiratory support
Article
Licensed
Unlicensed Requires Authentication

Thyroid function in late preterm infants in relation to mode of delivery and respiratory support

  • Renee M. Behme , Amy B. Mackley , Louis Bartoshesky and David A. Paul EMAIL logo
Published/Copyright: November 21, 2013
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 27 Issue 5-6

Abstract

The relationship between thyroid function, mode of delivery, and illness in infants 34–36 weeks’ gestation has not been well studied. We hypothesized that infants born by cesarean delivery and those with increased illness would have a reduction in thyroxine (T4) following birth. Total T4 and thyroid-stimulating hormone were obtained at birth (Time 1) and between days 2 and 5 (Time 2). The study sample included 129 infants 34–36 weeks’ gestation. There were no differences in total T4 between infants born by cesarean or vaginal delivery (p=0.18), or between those requiring respiratory support compared to infants not requiring respiratory support (p=0.09). At Time 2, 93% of the study population had a total T4 below one standard error of the reference laboratory mean. In our study sample, despite many infants having a low total T4, there was no association between total T4 levels, respiratory support, or mode of delivery.

Keywords: hypothyroxinemia; illness severity; late preterm; prematurity; respiratory distress; Clinicaltrials.gov: NCT00971555
Corresponding author: David A. Paul, Neonatology, Christiana Hospital, MAP 1, 217, 4745 Ogletown Stanton Rd, Newark, DE 19713, USA, Phone: +1 302 733 2410, E-mail:

References

1. Fisher DA, Nelson JC, Carlton EI, Wilcox RB. Maturation of human hypothalamic pituitary-thyroid function and control. Thyroid 2000;10:229–34.10.1089/thy.2000.10.229Search in Google Scholar

2. Fanaroff AA, Martin RJ, Walsh MC. Neonatal-perinatal medicine: diseases of the fetus and infant, 8th edition. Philadelphia, PA: Mosby, pp. 1544–55.Search in Google Scholar

3. Paul DA, Leef KH, Voss B, Stefano JL, Bartoshesky L. Thyroxine and illness severity in very low-birth-weight infants. Thyroid 2001;11:871–75.10.1089/105072501316973136Search in Google Scholar

4. Paul DA, Leef KH, Stefano JL, Bartoshesky L. Low serum thyroxine on initial newborn screening is associated with intraventricular hemorrhage and death in very low birth weight infants. Pediatrics 1998;101:903–07.10.1542/peds.101.5.903Search in Google Scholar

5. Reuss ML, Paneth N, Pinto-Martin JA, Lorenz JM, Susser M. The relation of transient hypothyroxinemia in preterm infants to neurologic development at two years of age. NEJM 1996;334:821–7.10.1056/NEJM199603283341303Search in Google Scholar

6. Leviton A, Paneth N, Reuss ML. Hypothyroxinemia of prematurity and the risk of cerebral white matter damage. J. Pediatrics 1999;134:706–11.10.1016/S0022-3476(99)70285-4Search in Google Scholar

7. Tahirovic HF. Transient hypothyroxinemia in neonates with birth asphyxia delivered by emergency cesarean section. J Pediatr Endocrinol 1994;7:39–41.10.1515/JPEM.1994.7.1.39Search in Google Scholar

8. Sak E, Akin M, Akturk Z. Investigation of the relationship between low Apgar scores and early neonatal thyroid function. Pediatr Int 2000;42:514–16.10.1046/j.1442-200x.2000.01275.xSearch in Google Scholar PubMed

9. Pereira DN, Procianoy RS. Effect of perinatal asphyxia on thyroid-stimulating hormone and thyroid hormone levels. Acta Paediatr 2003;92:339–45.10.1111/j.1651-2227.2003.tb00556.xSearch in Google Scholar

10. Lim DJ, Herring MK, Leef KH, Getchell J, Bartoshesky LE, et al. Hypothyroxinemia in mechanically ventilated term infants is associated with increased use of rescue therapies. Pediatrics 2005;115:406–10.10.1542/peds.2004-0192Search in Google Scholar PubMed

11. Shapiro-Mendoza CK, Tomashek KM, Kotelchuck M, Barfield W, Nannini A, et al. Effect of late-preterm birth and maternal medical conditions on newborn morbidity risk. Pediatrics 2008;121:e223–32.10.1542/peds.2006-3629Search in Google Scholar PubMed

12. Tomashek KM, Shapiro-Mendoza M, Davidoff M, Petrini J. Differences in mortality between late-preterm and term singleton infants in the United States, 1995–2002. J Pediatr 2007;151:450–56.10.1016/j.jpeds.2007.05.002Search in Google Scholar PubMed

13. Engle WA, Tomashek KM, Wallman C, and the Committee on Fetus and Newborn. “Late-preterm” infants: a population at risk. Pediatrics 2007;120:1390–401.10.1542/peds.2007-2952Search in Google Scholar PubMed

14. Carrascosa A, Ruiz-Cuevas P, Potau N, Almar J, Salcedo S, et al. Thyroid function in seventy-five healthy preterm infants thirty to thirty-five weeks of gestational age: a prospective and longitudinal study during the first year of life. Thyroid 2004;14:435–42.10.1089/105072504323150741Search in Google Scholar PubMed

15. Carrascosa A, Ruiz-Cuevas P, Clemente M, Salcedo S, Almar J. Thyroid function in 76 sick preterm infants 30–36 weeks: results from a longitudinal study. J Pediatr Endocrinol Metab 2008;21:237–43.10.1515/JPEM.2008.21.3.237Search in Google Scholar PubMed

16. Turan S, Bereket A, Angaji M, Koroglu OA, Bilgen H, et al. The effect of the mode of delivery on neonatal thyroid function. J. Maternal Fetal Neonatal Med 2007;20:473–76.10.1080/14767050701398314Search in Google Scholar PubMed

17. Miyamoto N, Tsuji M, Imataki T, Nagamachi N, Hirose S, et al. Influence of mode of delivery on fetal pituitary-thyroid axis. Acta Paediatr Jpn 1991;33:363–68.10.1111/j.1442-200X.1991.tb01567.xSearch in Google Scholar PubMed

18. Lao TT, Panesar NS. Neonatal thyrotrophin and mode of delivery. Br J Obstet Gynaecol 1989;96:1224–27.10.1111/j.1471-0528.1989.tb03201.xSearch in Google Scholar PubMed

19. Herbstman J, Apelberg BJ, Witter FR, Panny S, Goldman LR. Maternal, infant, and delivery factors associated with neonatal thyroid hormone status. Thyroid 2008;18:67–76.10.1089/thy.2007.0180Search in Google Scholar PubMed

20. Richardson DK, Gray JE, McCormick, MC, Workman K, Goldmann DA. Score for neonatal acute physiology: a physiologic severity index for neonatal intensive care. Pediatrics 1993;91:617–23.10.1542/peds.91.3.617Search in Google Scholar

21. De Luca R, Boulvain M, Irion O, Berner M, Pfister RE. Incidence of early neonatal mortality and morbidity after later preterm cesarean delivery. Pediatrics 2009;123: e1064–71.10.1542/peds.2008-2407Search in Google Scholar PubMed

22. Biswas S, Buffery J, Enoch H, Bland JM, Walters D, et al. A longitudinal assessment of thyroid hormone concentrations in preterm infants younger than 30 weeks gestation during the first 2 weeks of life and their relationship to outcome. Pediatrics 2002;109:222–27.10.1542/peds.109.2.222Search in Google Scholar PubMed

Received: 2013-6-13
Accepted: 2013-10-17
Published Online: 2013-11-21
Published in Print: 2014-5-1

©2014 by Walter de Gruyter Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Original articles
  3. Assessment of hearing in children with type 1 diabetes mellitus
  4. Insulin resistance and lipid profiles in HIV-infected Thai children receiving lopinavir/ritonavir-based highly active antiretroviral therapy
  5. Increased hunger and speed of eating in obese children and adolescents
  6. Glucagon and insulin cord blood levels in very preterm, late preterm and full-term infants
  7. Thyroid function in late preterm infants in relation to mode of delivery and respiratory support
  8. Prevalence of vitamin D deficiency and its related factors in children and adolescents living in North Khorasan, Iran
  9. Asymmetric dimethyl L-arginine, nitric oxide and cardiovascular disease in adolescent type 1 diabetics
  10. A combined nutritional-behavioral-physical activity intervention for the treatment of childhood obesity – a 7-year summary
  11. The effect of earlier puberty on cardiometabolic risk factors in Afro-Caribbean children
  12. Prevalence of risk of deficiency and inadequacy of 25-hydroxyvitamin D in US children: NHANES 2003–2006
  13. Serum uric acid: relationships with biomarkers in adolescents and changes over 1 year
  14. Psychological impact on parents of children with congenital adrenal hyperplasia: a study from Sri Lanka
  15. Investigation of adropin and leptin levels in pediatric obesity-related nonalcoholic fatty liver disease
  16. Diseases accompanying congenital hypothyroidism
  17. Molecular diagnosis of a Chinese pedigree with α-mannosidosis and identification of a novel missense mutation
  18. Are the characteristics of thyroid cancer different in young patients?
  19. Unsaturated fatty acids and insulin resistance in childhood obesity
  20. Effect of genetic subtypes and growth hormone treatment on bone mineral density in Prader-Willi syndrome
  21. KCNJ11 gene mutation analysis on nine Chinese patients with type 1B diabetes diagnosed before 3 years of age
  22. Prevalence and risk factors of metabolic syndrome in school adolescents of northeast China
  23. Patient reports
  24. A novel activating ABCC8 mutation underlying neonatal diabetes mellitus in an infant presenting with cerebral sinovenous thrombosis
  25. Endocrinological anomalies in a patient with 12q14 microdeletion syndrome. Completing phenotype of this exceptional short stature condition
  26. Acute mental status change as the presenting feature of adrenal insufficiency in a patient with autoimmune polyglandular syndrome type II and stroke
  27. Effect of ethosuximide on cortisol metabolism in the treatment of congenital adrenal hyperplasia
  28. Absence of WNT4 gene mutation in a patient with MURCS association
  29. Identification of a novel insulin receptor gene heterozygous mutation in a patient with type A insulin resistance syndrome
  30. Adrenal insufficiency in association with congenital nephrotic syndrome: a case report
  31. Diabetic lipemia presenting as eruptive xanthomas in a child with autoimmune polyglandular syndrome type IIIa
  32. A case report of nephrogenic diabetes insipidus with idiopathic Fanconi syndrome in a child who presented with vitamin D resistant rickets
  33. Letter to the Editor
  34. Hyperbilirubinemia in neonates of diabetic mothers: an indirect biomarker of organ damage?
https://doi.org/10.1515/jpem-2013-0243
Keywords for this article
hypothyroxinemia; illness severity; late preterm; prematurity; respiratory distress; Clinicaltrials.gov: NCT00971555

Articles in the same Issue

  1. Frontmatter
  2. Original articles
  3. Assessment of hearing in children with type 1 diabetes mellitus
  4. Insulin resistance and lipid profiles in HIV-infected Thai children receiving lopinavir/ritonavir-based highly active antiretroviral therapy
  5. Increased hunger and speed of eating in obese children and adolescents
  6. Glucagon and insulin cord blood levels in very preterm, late preterm and full-term infants
  7. Thyroid function in late preterm infants in relation to mode of delivery and respiratory support
  8. Prevalence of vitamin D deficiency and its related factors in children and adolescents living in North Khorasan, Iran
  9. Asymmetric dimethyl L-arginine, nitric oxide and cardiovascular disease in adolescent type 1 diabetics
  10. A combined nutritional-behavioral-physical activity intervention for the treatment of childhood obesity – a 7-year summary
  11. The effect of earlier puberty on cardiometabolic risk factors in Afro-Caribbean children
  12. Prevalence of risk of deficiency and inadequacy of 25-hydroxyvitamin D in US children: NHANES 2003–2006
  13. Serum uric acid: relationships with biomarkers in adolescents and changes over 1 year
  14. Psychological impact on parents of children with congenital adrenal hyperplasia: a study from Sri Lanka
  15. Investigation of adropin and leptin levels in pediatric obesity-related nonalcoholic fatty liver disease
  16. Diseases accompanying congenital hypothyroidism
  17. Molecular diagnosis of a Chinese pedigree with α-mannosidosis and identification of a novel missense mutation
  18. Are the characteristics of thyroid cancer different in young patients?
  19. Unsaturated fatty acids and insulin resistance in childhood obesity
  20. Effect of genetic subtypes and growth hormone treatment on bone mineral density in Prader-Willi syndrome
  21. KCNJ11 gene mutation analysis on nine Chinese patients with type 1B diabetes diagnosed before 3 years of age
  22. Prevalence and risk factors of metabolic syndrome in school adolescents of northeast China
  23. Patient reports
  24. A novel activating ABCC8 mutation underlying neonatal diabetes mellitus in an infant presenting with cerebral sinovenous thrombosis
  25. Endocrinological anomalies in a patient with 12q14 microdeletion syndrome. Completing phenotype of this exceptional short stature condition
  26. Acute mental status change as the presenting feature of adrenal insufficiency in a patient with autoimmune polyglandular syndrome type II and stroke
  27. Effect of ethosuximide on cortisol metabolism in the treatment of congenital adrenal hyperplasia
  28. Absence of WNT4 gene mutation in a patient with MURCS association
  29. Identification of a novel insulin receptor gene heterozygous mutation in a patient with type A insulin resistance syndrome
  30. Adrenal insufficiency in association with congenital nephrotic syndrome: a case report
  31. Diabetic lipemia presenting as eruptive xanthomas in a child with autoimmune polyglandular syndrome type IIIa
  32. A case report of nephrogenic diabetes insipidus with idiopathic Fanconi syndrome in a child who presented with vitamin D resistant rickets
  33. Letter to the Editor
  34. Hyperbilirubinemia in neonates of diabetic mothers: an indirect biomarker of organ damage?
Sign up now to receive a 20% welcome discount
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2025 De Gruyter Brill
Downloaded on 25.9.2025 from https://www.degruyterbrill.com/document/doi/10.1515/jpem-2013-0243/html
Scroll to top button