Evolution of congenital hypothyroidism in a cohort of preterm born children

Abstract

Background: Congenital hypothyroidism (CH) is reported to be more common in preterm infants than in term infants, especially in sick preterm infants. Though a frequent possibility of transitory thyroidal alterations in this category of neonates, the evolution of CH to transient or permanent forms is unpredictable. Methods: We retrospectively analyzed medical records of 28 preterm infants (<37 weeks gestation) who had exhibited a positive screening for CH at birth during the period 2000 e2015 followed in our Center. Children were divided into three groups: permanent CH (PCH) with thyroid dysgenesis, PCH with eutopic normal-sized thyroid gland, and transient CH (TCH) with eutopic normal-sized thyroid gland. In all groups we described clinical and biochemical characteristics. Secondly, we analyzed the differences between patients with thyroid dysgenesis and patients with eutopic normal-sized gland and we compared PCH and TCH groups with normal-sized thyroid gland in order to identify clinical or biochemical data for early detection of transient forms.Results: Of all patients, 21.4% showed thyroid dysgenesis while 78.6% presented eutopic normal-sized gland. Infants with thyroid dysgenesis had higher median (IQR) baseline s-TSH and levothyroxine (L-T4) dose per weight at 12 months (12 m-dose) than patients with eutopic normal-sized gland. At re-evaluation of the patients with eutopic normal-sized gland, 36% showed PCH and 64% had TCH. The age of the patients at the beginning of L-T4 treatment, gestational age (GA), birth weight, blood thyroid stimulating hormone levels (b-TSH) at first newborn screening (NBS), baseline serum thyroid stimulating hormone (s-TSH), and L-T4 12 m-dose were statistically different between the two groups. Conclusions: Our results demonstrate that factors as GA, birth weight, b-TSH levels at first NBS, baseline s-TSH, L-T4 12 m-dose and age at the start of the treatment may be considered useful predictive elements for the evolution of CH.

Cord Blood TSH and Free T4 Correlation with Maternal and Neonatal Factors and Heel-Stick TSH For the Early Detection of Congenital Hypothyroidism: A Cross-sectional Study in Iran

“…Umbilical cord blood TSH measurement has shown several advantages, including non-invasive, easy sampling, and recheck enabling even before the mother leaves the hospital. However, some studies have demonstrated that the values for CBTSH can be affected by a variety of maternal neonatal factors, while these reports were accompanied by paradoxical and different results (1,3,13,19). In this study, the data of effect of maternal and neonatal factors on cord blood Free T4 and TSH were demonstrated, which were studied in neonates born at Amir-Al-Momenin, Semnan, Iran.…”

“…Congenital hypothyroidism (CH) is the most frequent endocrine disorder in newborns. With increasing the incidence rate of congenital hypothyroidism during the past two decades, early diagnosis can dramatically decrease the burden of mentally retarded children in society (19). Umbilical cord blood TSH measurement has shown several advantages, including non-invasive, easy sampling, and recheck enabling even before the mother leaves the hospital.…”

Long-Term Course of Hypothyroidism Detected through Neonatal TSH Screening in a Population-Based Cohort of Very Preterm Infants Born at Less than 32 Weeks of Gestation

“…These previous studies examined the frequency of hypothyroidism within their respective cohorts without differentiating between severe and mild permanent hypothyroidism. [23,25,26,28,[32][33][34]. Detailed comparability between the studies was restricted because of the diversity of selected cohorts (e.g., (very) low birth weight, or preterms below 32, 33, or 37 weeks of gestation), differing screening algorithms (timing and cut-off values) and varying case definitions.…”

La Prematuridad Y Sus Factores Asociados: Una Revisión Narrativa De La Literatura

“…Nesse sentido, estudos demonstram que fatores como idade gestacional, peso ao nascer, níveis de b-TSH no primeiro NBS, s-TSH basal, dose de L-T4 12 m e idade no início do tratamento podem ser considerados elementos preditivos úteis para a evolução do hipotireodismo congênito (Scavone et al, 2020).…”