Correction: Lack of association between hypothyroxinemia of prematurity and transient thyroid abnormalities with adverse long term neurodevelopmental outcome in very low birth weight infants

Tan, Lay Ong; Tan, Mary Grace; Poon, Woei Bing

doi:10.1371/journal.pone.0223867

Cited by 5 publications

(2 citation statements)

References 1 publication

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“…Risk factors for THOP include infants with low gestational weeks, preeclampsia, intrauterine growth restriction, perinatal asphyxia, NEC, PDA, RDS, IVH, BPD, mechanical ventilation, and receiving medications such as dopamine or dexamethasone ( 17 , 18 , 19 , 20 , 21 ). Various studies have shown that some medications, as well as non-thyroidal diseases such as RDS, sepsis, IVH, PDA, and NEC, are associated with THOP, and the degree of hypothyroxinemia correlates with the severity of such diseases ( 22 , 23 , 24 ).…”

Section: Discussionmentioning

confidence: 99%

Neurodevelopmental Outcome of the Infants with Transient Hypothyroxinemia of Prematurity in Newborn Intensive Care Unit

Aygun,

Yilmaz Semerci,

Cakil Saglik

et al. 2023

Jcrpe

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Objective: The aim of this study was to evaluate neurological development of infants with transient premature hypothyroxinemia (THOP). Methods: This prospective study included newborns who were born between 28-36 weeks of gestation (GW) and were admitted to the neonatal intensive care unit. Newborns exposed to maternal thyroid disease, or with severe intracranial problems, and congenital anomalies were excluded. Infants with THOP were the study group and those without THOP formed the control group. The study group was subdivided into those receiving levothyroxine replacement (5 μg/kg/day) and those who were untreated. Neonatal demographics, and morbidities, including respiratory distress syndrome, bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) were evaluated. The Ages and Stages Questionnaire (ASQ) and ASQ:Social-Emotional (ASQ:SE) developmental screening tests were administered to the entire study population at the corrected age of two years. Results: Seventy infants were included in this study, 40 of whom had THOP. The mean GW was 34.4±3.8 weeks in the study group and 37.2±2.3 weeks in controls (p=0.69). Mean overall birth weight was 1640±428 g. Levothyroxine replacement was started in 12/40 infants (30%). The groups were similar in terms of demographic characteristics. Rates of BPD and ROP were higher in the treated group (p=0.01). ASQ and ASQ:SE results did not differ between groups (p=0.75), nor did these scores differ between infants with THOP who did or did not receive levothyroxine (p=0.14). Conclusion: Although levothyroxine replacement therapy was associated with increased rates of BPD and ROP, this treatment did not appear to improve long-term neurological outcomes in this small group of infants with THOP. Prospective controlled studies with much larger sample sizes are needed to clarify the role of levothyroxine replacement in THOP.

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Section: Discussionmentioning

confidence: 99%

Neurodevelopmental Outcome of the Infants with Transient Hypothyroxinemia of Prematurity in Newborn Intensive Care Unit

Aygun,

Yilmaz Semerci,

Cakil Saglik

et al. 2023

Jcrpe

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“…Hypothyroxinemia of prematurity is a well-described condition affecting between 35 and 85% preterm infants and is a major cause of a high rate of false-positives on tT4-based screening programs [ 22 ]. Currently, there is no evidence that early detection or treatment of transient hypothyroxinemia improves neurological prognosis, morbidity or mortality of this population, therefore, its detection should not be an objective of NS programs [ 22 , 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Reference Percentiles and Changes over Time for Total Thyroxine in Preterm Infants: A Retrospective Cohort Study

et al. 2020

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Hypothyroxinemia of prematurity increases the rate of false-positive results in total thyroxine (tT4)-based screening programs for congenital hypothyroidism. The use of specific cutoff values for preterm infants has been proposed, but data on tT4 reference ranges in this population are limited. The primary aim was to establish reference percentiles for tT4 in dried blood spots among Mexican preterm infants. Secondary aims included a comparison of the change of tT4 concentrations over time according to gestational age and to discuss its impact on tT4-based screening programs. This was a retrospective cohort study; 1561 preterm infants were included. Percentile 10th for tT4 concentration at 24–27, 28–30, 31–34, and 35–36 weeks of gestational age, measured in the first week of life was: 47.6, 56.6, 82.3, and 117.1 nmol/L, respectively. tT4 concentrations were compared in three different time points: first week of life, 2–3 weeks of life, and term-corrected gestational age (38 weeks of gestation), progressively increased in infants below 30 weeks, remained stable in infants from 31 to 34 weeks, and decreased in late preterm newborns (35–36 weeks). This study suggests that preterm infants may require the use of lower tT4 cutoff values in newborn screening.

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A study on normalization of hypothyroxinemia in neonates below 34 weeks of gestation

Gaonkar

Shenoi

Sathyanarayana³

et al. 2022

JPED

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Objectives: The aim of the study was to estimate the time required for normalization of hypothyroxinemia of prematurity in neonates below 34 weeks of gestation. Material and Methods: A retrospective study was conducted in neonates born below 34 weeks of gestation, between January 2015 and December 2016. Data were collected on free thyroxine (fT4) and thyroid-stimulating hormone (TSH) levels, tested on days 3, 14, 28, and 42. Gestational age, birth weight, use of antenatal steroids, mechanical ventilation, and various preterm morbidities, along with development at 18 months of corrected age, were comparatively analyzed in neonates with and without hypothyroxinemia. The median time for normalization of fT4 in all these variables was estimated. Results: On day 3, low fT4 was noted in 69 (37.7%) out of 183 neonates born below 34 weeks of gestation; all had normal TSH levels. Hypothyroxinemia showed statistically significant association with gestational age, birth weight, antenatal steroid use, respiratory distress syndrome, invasive ventilation, shock, sepsis, patent ductus arteriosus (PDA), anemia during stay in neonatal intensive care unit, and development at 18 months. Median time for normalization was 14 days in most of the neonates, and 28 days in those with <28 weeks of gestational age, weight of <1000 g and with shock, anemia, and PDA. Two infants with hypothyroxinemia received therapy with levothyroxine at 6 weeks for a short duration, as TSH was high. Conclusion: Hypothyroxinemia of prematurity takes 14–28 days to normalize based on maturity, weight, and illnesses. This study recommends serum fT4 testing at 2 weeks of life, provided congenital hypothyroidism was ruled out by 3–4 days of life, using direct blood spot card metabolic screening.

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Correction: Lack of association between hypothyroxinemia of prematurity and transient thyroid abnormalities with adverse long term neurodevelopmental outcome in very low birth weight infants

Abstract: Reference 1. Tan LO, Tan MG, Poon WB (2019) Lack of association between hypothyroxinemia of prematurity and transient thyroid abnormalities with adverse long term neurodevelopmental outcome in very low birth weight infants. PLoS ONE 14(9): e0222018.

Cited by 5 publications

References 1 publication

Neurodevelopmental Outcome of the Infants with Transient Hypothyroxinemia of Prematurity in Newborn Intensive Care Unit

Neurodevelopmental Outcome of the Infants with Transient Hypothyroxinemia of Prematurity in Newborn Intensive Care Unit

Reference Percentiles and Changes over Time for Total Thyroxine in Preterm Infants: A Retrospective Cohort Study

A study on normalization of hypothyroxinemia in neonates below 34 weeks of gestation

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