Congenital Hypothyroidism in Preterm Newborns – The Challenges of Diagnostics and Treatment: A Review

Klosinska, Martyna; Kaczyńska, Agnieszka; Beń‐Skowronek, Iwona

doi:10.3389/fendo.2022.860862

Cited by 18 publications

(22 citation statements)

References 114 publications

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“…Therefore, we would recommend running an additional screening in that group of newborns. A similar recommendation was given by others ( 11 – 14 ).…”

Section: Discussionmentioning

confidence: 58%

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The prevalence of hypothyroxinemia in premature newborns

et al. 2022

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Congenital hypothyroidism diagnosed by TSH assessment in bloodspot screening may be overlooked in preterm newborns due to immaturity of the hypothalamus-pituitary-thyroid axis in them. The purpose of the study was to determine the prevalence and causes of hypothyroxinemia in preterm newborns, determined by TSH and FT4 serum concentration measurement, performed on the 3-5th day of life. We assessed TSH, FT4 and FT3 serum concentration on the 3-5th day of life in preterm children born at our centre within three consecutive years. We assessed the incidence of hypothyroxinemia, and its cause: primary hypothyroidism, secondary hypothyroidism or low FT4 syndrome - with normal TSH concentration, its dependence - among others - on gestational age (GA), birth body weight (BBW) and being SGA. A total of 525 preterm children were examined. FT4 concentration was decreased in 14.9% of preterm newborns. The most frequent cause of hypothyroxinemia was low FT4 syndrome (79.5%). More than 92% cases of hypothyroxinemia occurred in children born before the 32nd week and/or with BBW below 1500 g. Thus, every fourth child in these groups had a reduced FT4 concentration. Neonates with hypothyroxinemia were significantly lighter than those with normal FT4. In older and heavier neonates with hypothyroxinemia, serious congenital defects were observed. Neither IVH nor SGA nor twin pregnancies predispose children to hypothyroxinemia. Among newborns with untreated hypothyroxinemia in whom TSH and FT4 assessment was repeated within 2-5 weeks, a decreased FT4 concentration was confirmed in 56.1% of cases. As hypothyroxinemia affects 25% of newborns born before the 32nd week of gestation and those in whom BBW is less than 1500g, it seems that in this group of children the newborn screening should be extended to measure serum TSH and FT4 concentration between the 3-5th day of life. In older and heavier neonates, additional serum TSH and FT4 assessment should be limited to children with severe congenital abnormalities but not to all SGA or twins. Despite the fact that the most common form of preterm hypothyroxinemia is low FT4 syndrome, it should be emphasized that FT4 remains lowered on subsequent testing in more them 50% of cases.

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“…Therefore, we would recommend running an additional screening in that group of newborns. A similar recommendation was given by others ( 11 – 14 ).…”

Section: Discussionmentioning

confidence: 58%

“…However, the reports of the benefits of LT4 treatment in premature infants with hypothyroxinemia are divergent ( 4 , 14 , 27 , 28 ). In our group, it was difficult to predict in which children hypothyroxinemia would persist and in which it would be transient and FT4 would normalize without treatment.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of hypothyroxinemia in premature newborns

et al. 2022

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“…Dessa maneira, a diminuição do nível de tiroxina, independentemente da causa, pode levar ao atraso no desenvolvimento mental. Por isso, é tão importante o diagnóstico precoce, assim como a realização do teste do pezinho (KLOSINSKA M, et al, 2022).…”

Section: Ações Neuronais Dos Hormônios Tireoidianosunclassified

Consequências do hipotireoidismo congênito no desenvolvimento infantil

et al. 2023

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Objetivo: Avaliar as consequências do hipotireoidismo congênito no desenvolvimento da criança. Revisão bibliográfica: O Hipotireoidismo Congênito (HC) pode ser classificado em primário, secundário ou terciário e é decorrente da incapacidade da tireoide de produzir T3 e T4, que são hormônios responsáveis por diversas funções. Quando esses hormônios se encontram abaixo dos níveis ideais, podem causar prejuízos, uma vez que são essenciais para o desenvolvimento do sistema nervoso central. Um dos principais fatores de risco é o histórico familiar, seguido pelo sexo masculino. O diagnóstico precoce é essencial e ocorre por meio do teste de pezinho na triagem neonatal. Assim que for detectada a disfunção, o tratamento deve ser realizado com comprimidos por via oral diariamente do hormônio T4. Considerações finais: Fica claro que o HC tem consequências graves para o recém-nascido por afetar o desenvolvimento cognitivo e físico. Dessa forma, é primordial realizar o diagnóstico precoce e o tratamento em tempo oportuno para evitar o retardo mental irreversível.

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“…Therefore, accurate diagnosis and differentiation between subtypes of CH is very important to plan an effective treatment. (7). Transient congenital hypothyroidism (CH) refers to a temporary deficiency of thyroid hormone, characterized after birth by low thyroxine (T4) and high thyrotropin (TSH), which later recovers and 1 Congenital hypothyroidism thyroxine production recovers, usually in The first few months of infancy.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, accurate diagnosis and differentiation between subtypes of CH is very important to plan an effective treatment. (7).…”

Section: Introductionmentioning

confidence: 99%

Investigation of risk factors for congenital hypothyroidism (CH) using a population-based case-control study as part of the 2015-2018 screening program in Kohgiluyeh and Boyer Ahmad province in southwestern Iran

Jamali,

Bokaie,

Bahonar

et al. 2024

Preprint

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Introduction and objectives: Congenital hypothyroidism (CH) is a lack of thyroid hormone at birth, crucial for brain development. A nationwide screening program has been implemented in Iran since 2005, resulting in over 12 million infants being screened and more than 30,000 patients diagnosed and treated. The incidence of CH in Iran is 2.7 per thousand live births, which is higher compared to the global incidence of 1 in 3,000 to 4,000. The incidence of CH in Kohgiluyeh and Boyer Ahmad province is significantly higher than the national and global incidence. Prognostic factors including twins, the season of birth, puberty, jaundice at birth, birth weight, gestational age, anemia and goiter of the mother, type of delivery, father's education, and smoking status are significantly associated with CH. Genetic, climatic, and environmental factors also play a role in the development of CH. Congenital hypothyroidism (CH) is one of the most common causes of intellectual disability, which can be prevented if diagnosed and treated on time. We aimed to investigate some related risk factors for CH in infants born in Kohgiluyeh and Boyer Ahmad province. Results: This was a population-based case-control study conducted on 270 infants. The study population included infants who were born between 2015 and 2018 and were subjected to a screening program for CH. In general, 135 infants diagnosed with CH who were confirmed by a specialist and had a medical record were considered as the case group and the rest (135 infants) who were healthy were considered as controls. Patients and control infants were matched in a one-to-one ratio. Information was extracted from the Sib Health Integrated System (http://sib.yums.ac.ir). Regression analysis using the logistic regression method was performed on data collected from a sample of 270 infants and SPSS software version 24 was used to analyze the data with P<0.05 considered significant. Ethical considerations were addressed by obtaining approval from the ethics committee of Yasuj University of Medical Sciences under ethical number IR.YUMS.REC.1397.136 and holding preliminary meetings with authorities, health, and medical personnel to discuss different tasks, collaboration, and completion of checklists. Conclusion: The results of the study show that among the cases studied, 3 factors, weight and height of the infant at birth and a family history of the disease in the infant could be the main risk factors for hypothyroidism (CH) in this province. Other factors such as birth order (rank), maternal age, maternal weight and height, age and mode of delivery, history of medication and iodized salt intake in the mother, diseases of the mother and father, and familial relationship of the parents were not observed to have a statistically significant association with CH. further studies are needed to analyze the results of the present study to establish the causality of these associations with greater certainty. Keywords: Neonatal hypothyroidism, risk factors, case-control study, screening, Kohgiloyeh, and Boyer Ahmad, Iran

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Congenital Hypothyroidism in Preterm Newborns – The Challenges of Diagnostics and Treatment: A Review

Cited by 18 publications

References 114 publications

The prevalence of hypothyroxinemia in premature newborns

The prevalence of hypothyroxinemia in premature newborns

Consequências do hipotireoidismo congênito no desenvolvimento infantil

Investigation of risk factors for congenital hypothyroidism (CH) using a population-based case-control study as part of the 2015-2018 screening program in Kohgiluyeh and Boyer Ahmad province in southwestern Iran

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