Low Serum Thyroxine on Initial Newborn Screening Is Associated With Intraventricular Hemorrhage and Death in Very Low Birth Weight Infants

Paul, David A.; Leef, Kathleen H; Stefano, John L.; Bartoshesky, Louis

doi:10.1542/peds.101.5.903

Cited by 86 publications

(43 citation statements)

References 16 publications

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“…NTIS and iodine deficiency also may contribute in some individuals 12, 14. The clinical relevance of THOP is that premature infants with low TH concentrations are at increased risk for neurodevelopmental abnormalities, respiratory disease, intraventricular hemorrhage, cerebral white matter damage, and higher morbidity and mortality 12, 30, 36, 37, 38. In the present study, TT4 and fT4D concentrations were not lower in sick foals than in normal foals, whereas premature foals had significantly lower concentrations of TT4 and fT4D compared to both sick and normal foals.…”

Section: Discussionmentioning

confidence: 99%

Thyroid Function and Dysfunction in Term and Premature Equine Neonates

Breuhaus

2014

Veterinary Internal Medicne

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BackgroundThis study was performed to compare thyroid function of premature foals to term foals.HypothesisPremature foals are more markedly hypothyroxinemic than expected for their severity of illness alone.AnimalsTwenty clinically normal term foals; 28 sick, hospitalized term foals; 24 sick, hospitalized premature foals.MethodsThyroid hormones (TH) and thyrotropin (TSH) were measured, both at rest and in response to thyrotropin‐releasing hormone (TRH), in the 3 groups of foals. Clinical and clinicopathologic data were recorded.ResultsNormal foals had high TH at birth, which decreased over the first month into the normal reference range for adult horses. TSH was within the normal adult reference range soon after birth, and did not change over time. At 24–36 hours of age, triiodothyronine (T3) was significantly lower in both premature and term hospitalized foals compared to normal foals; premature foals were not different from term hospitalized foals. Thyroxine (T4) was not different between normal and term hospitalized foals, but was significantly lower than in premature foals of both of these groups. TSH was not different among the 3 groups. TRH stimulation tests identified significant differences in T4 among all 3 groups of foals, whereas T3 was similar in premature and term hospitalized foals and different from normal foals. TSH response to TRH was significantly higher in premature foals compared to normal foals.Conclusions and Clinical ImportanceThe hypothalamic‐pituitary‐thyroid axis is different in foals compared to adult horses. Sick foals exhibit nonthyroidal illness syndrome. Premature foals are more markedly hypothyroxinemic than can be accounted for by their severity of illness alone.

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Section: Discussionmentioning

confidence: 99%

Thyroid Function and Dysfunction in Term and Premature Equine Neonates

Breuhaus

2014

Veterinary Internal Medicne

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“…This condition usually resolves within 2 to 3 weeks with progressive maturation of the hypothalamic-pituitary-thyroid axis. 10,11 As no consensus exists for THOP reference ranges, prevalence rates vary by study definition, with 35% 12 to 85% 13 of VPT infants reported to be affected.…”

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Free Thyroxine Levels After Very Preterm Birth and Neurodevelopmental Outcomes at Age 7 Years

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Preterm infants have transiently lowered thyroid hormone levels during the early postnatal period. Past research suggests that low thyroid hormone levels are related to cognitive and developmental deficits in children born preterm. WHAT THIS STUDY ADDS:Contrary to expectations, in this study of children born ,30 weeks' gestation, higher concentrations of free thyroxine over the first 6 weeks of life were associated with poorer cognitive function at 7 years of age. abstract BACKGROUND AND OBJECTIVES: Preterm infants commonly have transient hypothyroxinemia of prematurity after birth, which has been associated with deficits in general intellectual functioning, memory, attention, and academic achievement. However, research has predominantly focused on thyroxine levels in the first 2 weeks of life and outcomes are limited to the preschool period. Our objective was to evaluate the relationships between free thyroxine (fT 4 ) levels over the first 6 weeks after very preterm (VPT) birth with cognitive functioning and brain development at age 7 years. METHODS:A total of 83 infants born VPT (,30 weeks' gestation) had fT 4 concentrations measured postnatally and 2-and 6-week area under the curve (AUC) summary measures were calculated. Follow-up at age 7 years included a neuropsychological assessment and brain MRI. Univariable and multivariable regression modeling was used where AUC for fT 4 was the main predictor of neurodevelopmental outcome at age 7 years.RESULTS: Multivariable modeling revealed that higher, not lower, postnatal fT 4 levels (2-week AUC) were associated with poorer cognitive performances at age 7 years on tasks of verbal learning (P = .02), verbal memory (P = .03), and simple reaction time (P , .001). A similar pattern of results was found when the 6-week AUC was examined. No significant associations between postnatal fT 4 levels and brain volumes at age 7 years were identified. CONCLUSIONS:Results are contradictory to previous observations and suggest that after adjustment for confounders, higher postnatal fT 4 levels in VPT infants, rather than lower levels, may be a marker of adverse neuropsychological development in childhood. Dr Scratch conceptualized and designed the study, analyzed the data, and drafted the initial manuscript; Dr Hunt collected the blood specimens for hormone analysis, was involved in initial cerebral MRI interpretation, assisted with the conceptualization and design of the study, supervised data collection at all time points, and reviewed and revised the manuscript; Dr Thompson supervised the collection and analysis of the MRI scans and reviewed and revised the manuscript; Ms Ahmadzai performed the post-acquisition analysis of the MRI scans and reviewed and revised the manuscript; Dr Doyle assisted with the conceptualization and design of the study, supervised data collection at all time points, and reviewed and revised the manuscript; Dr Inder was involved in initial cerebral MRI interpretation, assisted with the conceptualization and design of the ...

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“…In considerazione dell'importante ruolo degli ormoni tiroidei nello sviluppo dell'apparato respiratorio, del SNC e dell'intero metabolismo del soggetto, risulta fondamentale stabilire l'effettiva funzionalità tiroidea del neonato SGA, al fine di ottimizzare una eventuale terapia ormonale sostitutiva [19][20][21][22][23][24].…”

Section: Introduzioneunclassified

“…Il neonato SGA presenta fin dall'epoca di vita fetale, alterazioni endocrino-metaboliche che determinano un aumentato rischio di mortalità e morbidità perinatali [4][5][6]15] e , secondo alcuni AA., di sviluppare malattie cardiovascolari in età adulta [7][8][9][10]. Pochi sono i lavori che hanno valutato i livelli degli ormoni tiroidei (TH) in neonati SGA sia durante la vita fetale, che nel cordone, che nelle prime epoche di vita e i risultati ottenuti sono discordanti [11][12][13][14][15][16][17][18].In considerazione dell'importante ruolo degli ormoni tiroidei nello sviluppo dell'apparato respiratorio, del SNC e dell'intero metabolismo del soggetto, risulta fondamentale stabilire l'effettiva funzionalità tiroidea del neonato SGA, al fine di ottimizzare una eventuale terapia ormonale sostitutiva [19][20][21][22][23][24]. …”

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Screening Test for Congenital Hypothyroidism: Thyroid Stimulating Hormone (Tsh) and Thyroxine (T4) in the Adapted for Gestational Age Newborn (Aga) and in the Small for Gestational Age Newborn (Sga) at Term and Preterm

et al. 2013

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InTrODUZIOneCirca il 15% dei neonati nasce piccolo per l'età gestazionale (SGA). Si definisce SGA il neonato il cui peso alla nascita è almeno 2DS inferiore alla media del peso dei neonati in quella fascia di età. Molti sono i fattori implicati nella nascita di un neonato SGA, tra cui: il potenziale genetico, lo stato di nutrizione e la presenza di malattie nella madre, la funzione placentare, il trasferimento di nutrienti, gli ormoni e i fattori di crescita intrauterini [1][2][3]. Il neonato SGA presenta fin dall'epoca di vita fetale, alterazioni endocrino-metaboliche che determinano un aumentato rischio di mortalità e morbidità perinatali [4][5][6]15] e , secondo alcuni AA., di sviluppare malattie cardiovascolari in età adulta [7][8][9][10]. Pochi sono i lavori che hanno valutato i livelli degli ormoni tiroidei (TH) in neonati SGA sia durante la vita fetale, che nel cordone, che nelle prime epoche di vita e i risultati ottenuti sono discordanti [11][12][13][14][15][16][17][18].In considerazione dell'importante ruolo degli ormoni tiroidei nello sviluppo dell'apparato respiratorio, del SNC e dell'intero metabolismo del soggetto, risulta fondamentale stabilire l'effettiva funzionalità tiroidea del neonato SGA, al fine di ottimizzare una eventuale terapia ormonale sostitutiva [19][20][21][22][23][24]. SCOPOValutare se la funzionalità tiroidea del neonato a termine e pretermine SGA in 2°-3° giornata di vita differisce da quella del neonato AGA di pari età gestazionale. Abstract. The small for gestational age newborn (SGA), which compared the adapted for gestational age newborn (AGA), has a higher risk of perinatal mortality and morbidity, also according to some authors of developing cardiovascular disease in adulthood. To establish if thyroid function of the newborn term and preterm SGA, in 2nd and 3rd day of life differs from that of the AGA infant of the same gestational age (GA). The levels of TSH and tT4 in 2nd and 3rd day of life were examined and obtained with the Screening for Congenital Hypothyroidism in a population of 1,958 infants, of which 1,671 resulted in AGA and 287 resulted in SGA. The overall population was divided into eight groups in relation to different [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. For each age range or group (AGA and SGA) in which the population was divided, the median of the values obtained for TSH and tT4 was measured. TSH levels were higher in SGA infants at different GAs considered (significantly 31-32 wks: p=0.0428 and 37-38 wks: p=0.0149), with the exception of infants aged 26-28 wks, whose TSH levels were significantly lower: p=0.0591 compared with AGA infants of the same GA. Instead, in the levels of tT4 in the SGA, newborn findings were lower than those of AGA infants at all gestational ages considered, but significantly only at 26-28 wks: p=0.0001 and 39-42 wks: p=0.0190. tT4 levels show a linear and significant increase with the advancing of GA, reaching the highest values in term newborns at 39-42 wks, both in overall populations (AGA and SG...

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Low Serum Thyroxine on Initial Newborn Screening Is Associated With Intraventricular Hemorrhage and Death in Very Low Birth Weight Infants

Cited by 86 publications

References 16 publications

Thyroid Function and Dysfunction in Term and Premature Equine Neonates

Thyroid Function and Dysfunction in Term and Premature Equine Neonates

Free Thyroxine Levels After Very Preterm Birth and Neurodevelopmental Outcomes at Age 7 Years

Screening Test for Congenital Hypothyroidism: Thyroid Stimulating Hormone (Tsh) and Thyroxine (T4) in the Adapted for Gestational Age Newborn (Aga) and in the Small for Gestational Age Newborn (Sga) at Term and Preterm

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