Reference intervals for neonatal thyroid function tests in the first 7 days of life
-
Michelle S. Jayasuriya
,
Lit K. Chin
Abstract
Background:
Prompt intervention can prevent permanent adverse neurological effects caused by neonatal hypothyroidism. Thyroid function changes rapidly in the first few days of life but well-defined age-specific reference intervals (RIs) for thyroid-stimulating hormone (TSH), free thyroxine (FT4) and free tri-iodothyronine (FT3) are not available to aid interpretation. We developed hour-based RIs using data mining.
Methods:
All TSH, FT4 and FT3 results with date and time of collection from neonates aged <7 days during 2005–2015 were extracted from the Monash Pathology database. Neonates with more than one episode of testing or with known primary hypothyroidism, identified by treating physicians or from medical records, were excluded from the analysis. The date and time of birth were obtained from the medical records.
Results:
Of the 728 neonates qualifying for the study, 569 had time of birth available. All 569 had TSH, 415 had FT4 and 146 had FT3 results. For age ≤24 h, 25–48 h, 49–72 h, 73–96 h, 97–120 h, 121–144 h and 145–168 h of life, the TSH RIs (2.5th–97.5th) (mIU/L) were 4.1–40.2, 3.2–29.6, 2.6–17.3, 2.2–14.7, 1.8–14.2, 1.4–12.7 and 1.0–8.3, respectively; the FT4 RIs (mean ± 2 standard deviation [SD]) (pmol/L) were 15.3–43.6, 14.7–53.2, 16.5–45.5, 17.8–39.4, 15.3–32.1, 14.5–32.6 and 13.9–30.9, respectively; the FT3 RIs (mean±2 SD) (pmol/L) were 5.0–9.4, 4.1–9.1, 2.8–7.8, 2.9–7.8, 3.5–7.2, 3.4–8.0 and 3.8–7.9, respectively.
Conclusions:
TSH and FT4 were substantially high in the first 24 h after birth followed by a rapid decline over the subsequent 168 h. Use of hour-based RIs in newborns allows for more accurate identification of neonates who are at risk of hypothyroidism.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organisation(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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©2018 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Original Articles
- The associations between mental health, health-related quality of life and insulin pump therapy among children and adolescents with type 1 diabetes
- Achieving target levels for vascular risk parameters in Polish school-age children with type 1 diabetes – a single center study
- Adipocyte aquaporin 7 (AQP7) expression in lean children and children with obesity. Possible involvement in molecular mechanisms of childhood obesity
- Use of complementary and alternative medicine in patients with inherited metabolic disease
- Are breast milk adipokines affected by maternal dietary factors?
- Comparison of serum 25-hydroxyvitamin D levels between radioimmunoassay and liquid chromatography-tandem mass spectrometry in infants and postpartum women
- Reference intervals for neonatal thyroid function tests in the first 7 days of life
- Treatment outcomes in pediatric differentiated thyroid carcinoma
- Seasonality of month of birth in children and adolescents with autoimmune thyroiditis: a continuing conundrum
- Follow-up in children with non-obese and non-autoimmune subclinical hypothyroidism
- Glucose intolerance in children with cystic fibrosis: a developing country’s perspective
- Letter to the Editor
- A patient with classical galactosemia is graduated with a university degree
- Case Reports
- Prepubertal gynaecomastia in a boy with Peutz-Jeghers syndrome: managing the aromatase overexpression
- Hypogammaglobulinemia and imaging features in a patient with infantile free sialic acid storage disease (ISSD) and a novel mutation in the SLC17A5 gene
- Xanthogranuloma of the sellar region accompanied by growth hormone deficiency: case report and literature review
- A case of Graves’ disease associated with membranoproliferative glomerulonephritis and leukocytoclastic vasculitis
Articles in the same Issue
- Frontmatter
- Original Articles
- The associations between mental health, health-related quality of life and insulin pump therapy among children and adolescents with type 1 diabetes
- Achieving target levels for vascular risk parameters in Polish school-age children with type 1 diabetes – a single center study
- Adipocyte aquaporin 7 (AQP7) expression in lean children and children with obesity. Possible involvement in molecular mechanisms of childhood obesity
- Use of complementary and alternative medicine in patients with inherited metabolic disease
- Are breast milk adipokines affected by maternal dietary factors?
- Comparison of serum 25-hydroxyvitamin D levels between radioimmunoassay and liquid chromatography-tandem mass spectrometry in infants and postpartum women
- Reference intervals for neonatal thyroid function tests in the first 7 days of life
- Treatment outcomes in pediatric differentiated thyroid carcinoma
- Seasonality of month of birth in children and adolescents with autoimmune thyroiditis: a continuing conundrum
- Follow-up in children with non-obese and non-autoimmune subclinical hypothyroidism
- Glucose intolerance in children with cystic fibrosis: a developing country’s perspective
- Letter to the Editor
- A patient with classical galactosemia is graduated with a university degree
- Case Reports
- Prepubertal gynaecomastia in a boy with Peutz-Jeghers syndrome: managing the aromatase overexpression
- Hypogammaglobulinemia and imaging features in a patient with infantile free sialic acid storage disease (ISSD) and a novel mutation in the SLC17A5 gene
- Xanthogranuloma of the sellar region accompanied by growth hormone deficiency: case report and literature review
- A case of Graves’ disease associated with membranoproliferative glomerulonephritis and leukocytoclastic vasculitis
