scholarly journals Age-specific correlation between thyroid hormone concentrations and ultrasound thyroid volume for diagnosing thyroid dysfunction in preterm infants: a single-centre, prospective, observational study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051097
Author(s):  
Aleksandra Mikołajczak ◽  
Katarzyna Kufel ◽  
Renata Bokiniec
Keyword(s):  
Thyroid Hormone ◽  
Preterm Infants ◽  
Study Protocol ◽  
Gestational Age ◽  
Hormone Replacement ◽  
Thyroid Volume ◽  
Reference Ranges ◽  
Thyroid Ultrasound ◽  
Single Centre ◽  
Congenital Diseases

IntroductionThyroid disorders are commonly concomitant with premature birth; however, indications to start therapy remain unclear due to lack of gestational age-specific reference ranges and thyroid ultrasound nomograms. We aim to evaluate the age-specific correlation between circulating free thyroxine (FT4) and thyrotropin stimulating hormone (TSH) levels and ultrasound thyroid volume to assist identify infants requiring thyroid hormone replacement therapy.Methods and analysisThis is an observational, prospective, single-centre study that will include 200 preterm infants born between 24 and 32 weeks of gestational age, without any congenital diseases or malformation that may affect thyroid function. Venous blood will be obtained in infants at 14–21 days of life, and at 32 and 36 weeks of postconceptional age (PCA) to measure FT4 and TSH concentrations. Thyroid ultrasound will be performed at 32 and 36 weeks of PCA. Relevant outcomes will include determination of FT4 and TSH values and ultrasound thyroid volume for preterm infants born at 24–28 weeks of gestation and 29–32 weeks of gestation. Correlations among circulating hormone concentrations and thyroid volumes with the head circumference and body mass will also be determined.Ethics and disseminationThe Ethics Committee of the Medical University of Warsaw has approved the study protocol prior to recruitment (KB44/2019). Informed consent will be obtained from caretakers of preterm infants at the time of enrolment. Consent for participation in the study can be withdrawn at any time, without consequences and without obligation to justify the decision. All data will be stored in a secure, password-protected Excel file that is only accessible to researchers involved in the study. Findings will be published in a peer-reviewed journal and disseminated at relevant national and international conferences.Trial registration numberNCT04208503.

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

Diagnostics ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 475
Author(s):  
Claudia M. Flores-Robles ◽  
Ernesto Roldan-Valadez ◽  
Nayeli Martínez-Cruz ◽  
Lidia Arce-Sánchez ◽  
Ana L. Priego-Zurita ◽  
...  
Keyword(s):  
Cohort Study ◽  
Preterm Infants ◽  
Gestational Age ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Reference Ranges ◽  
Screening Programs ◽  
Cutoff Values ◽  
Total Thyroxine ◽  
Over Time

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.

Postnatal thyroid hormone replacement in very preterm infants

2001 ◽  
Vol 25 (6) ◽  
pp. 417-425 ◽  
Author(s):  
Joke H. Kok ◽  
Judy M. Briet ◽  
Aleid G. van Wassenaer
Keyword(s):  
Thyroid Hormone ◽  
Preterm Infants ◽  
Hormone Replacement ◽  
Thyroid Hormone Replacement ◽  
Very Preterm Infants ◽  
Very Preterm

scholarly journals Evolution of circulating thyroid hormone levels in preterm infants during the first week of life: perinatal influences and impact on neurodevelopment

2019 ◽  
Vol 32 (6) ◽  
pp. 597-606 ◽  
Author(s):  
An Eerdekens ◽  
Gunnar Naulaers ◽  
Els Ortibus ◽  
Johan Verhaeghe ◽  
Lies Langouche ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Preterm Infants ◽  
Gestational Age ◽  
Infant Development ◽  
Neurodevelopmental Outcome ◽  
Thyroid Stimulating Hormone ◽  
Low T3 ◽  
Increased Risk ◽  
Total Thyroxine ◽  
The Impact

Abstract Background For several decades, transient hypothyroxinemia of prematurity (THOP) has been a topic of debate. The pathophysiology is incompletely understood and consensus on the therapeutic approach is lacking. This study aimed at gaining a better insight into the pathogenesis by studying the trends in thyroid hormone (TH) levels during the first week of life. Methods This single-center prospective observational study analyzed the plasma levels of total thyroxine (T4) and free thyroxine (fT4), total triiodothyronine (T3), thyroid-stimulating hormone (TSH) and T4-binding globulin (TBG) in cord blood and at the end of the first week of life in 120 preterm infants (gestational age [GA] <37 weeks). The change over time was calculated (delta, ∆). The impact of perinatal and subsequently postnatal variables on ∆ was studied by hierarchical multiple regression. The impact of ∆ on the neurodevelopmental outcome at the corrected ages of 9 and 24 months, measured by the Bayley Scales of Infant Development (BSID)-II, was assessed by logistic regression. Results ∆fT4 levels were negatively affected by GA and use of dopamine, whereas only GA was associated with low ∆T3 levels. Negative ∆fT4 levels were present in 75% of the extremely low-for-gestational-age infants, whereas 23.5% had a negative ∆T3 level. There was an increased risk for an abnormal mental developmental score (<85) with decreasing ∆T3 at 9 months, corrected age, but not at 24 months. Conclusions A negative evolution in circulating TH levels is principally an immaturity phenomenon, whereas dopamine can further suppress the hypothalamic-pituitary-thyroid axis. There is at least a temporary negative effect of this evolution on the infants’ neurodevelopment.

scholarly journals Thyroid hormone profile in apparently healthy pregnant women attending in a tertiary care hospital of Bangladesh

2016 ◽  
Vol 8 (2) ◽  
pp. 91
Author(s):  
Murshed Ahamed Khan ◽  
M.A. Hasanat ◽  
Md. Jahangir Alam ◽  
Md. Anwar Hossain ◽  
Ahmed Abu Saleh ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Gestational Age ◽  
Tertiary Care ◽  
American Thyroid Association ◽  
Reference Ranges ◽  
Care Hospital ◽  
Cross Sectional ◽  
Hormone Profile

<p><strong>Background:</strong> Thyroid dysfunction is not uncommon in pregnancy. It should be evaluated for better outcome of pregnancy.</p><p><strong>Objective:</strong> To observe the thyroid hormone profile in apparently euthyroid pregnant women of any trimester. Methods: This cross-sectional study investigated 350 pregnant women irrespective of gestational age [(age 24±4, m±SDyr; 1st trimester = 101, 2nd trimester=111, 3rd trimester=138) for thyroid stimulating hormone (TSH) and for free thyroxine (FT4)] to assess their thyroid function during pregnancy following the criteria of American Thyroid Association (ATA).</p><p><strong>Results:</strong> Most of the mothers were housewifes (93.1 %, 326/350) of whom 46.6% were primigravida. About 63% mother had associated goiter, 58% (204/350) were euthyroid and 41 % (142/350) were subclinical hypothyroid (SCH). Frequency of goiter (63% vs. 62%, euthyroid vs. dysfunction) was not significantly different between dysfunction and normal groups. FT4 significantly correlated with gestational age (r= - 0.131, p=0.014) and TSH level (r= - 0.612, p&lt; 0.001).</p><p><strong>Conclusion:</strong> It is concluded that many of the apparently euthyroid pregnant mother have dysfunction as defined by ATA reference ranges for TSH and FT4. Simple screening for thyroid function may have greater implication for better pregnancy outcome.</p>

scholarly journals Thyroid Hormone Supplementation in Preterm Infants Born Before 28 Weeks Gestational Age and Neurodevelopmental Outcome at Age 36 Months

Thyroid ◽  
2014 ◽  
Vol 24 (7) ◽  
pp. 1162-1169 ◽  
Author(s):  
Aleid van Wassenaer-Leemhuis ◽  
Susana Ares ◽  
Sergio Golombek ◽  
Joke Kok ◽  
Nigel Paneth ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Preterm Infants ◽  
Gestational Age ◽  
Neurodevelopmental Outcome

Discriminating necrotising enterocolitis and focal intestinal perforation

2021 ◽  
pp. fetalneonatal-2020-321429
Author(s):  
Janet Berrington ◽  
Nicholas D Embleton
Keyword(s):  
Clinical Trials ◽  
Quality Improvement ◽  
Preterm Infants ◽  
Gestational Age ◽  
Intestinal Perforation ◽  
Necrotising Enterocolitis ◽  
Single Centre ◽  
Detailed Review ◽  
Focal Intestinal Perforation ◽  
Key Features

Discriminating necrotising enterocolitis (NEC) and focal intestinal perforation (FIP) is important for clinical trials, observational cohorts, quality improvement and aetiological understanding. Literature suggests that timing and key features diagnose and discriminate, and that NEC subclassifications exist. We used a detailed 10-year cohort of NEC and FIP cases in preterm infants born <32 weeks’ gestation from a single centre to explore antecedent factors, presentation and potential NEC subclassifications. 785 infants had 144 episodes of NEC and 38 of FIP. FIP presented earlier than NEC, but ranges overlapped, and 30% of NEC presented before day 14. Antecedent events (other than feed volumes) and outcomes did not differ between NEC and FIP. Currently used diagnostic/discriminatory features performed poorly, and subclassification identified few cases except transfusion-associated NEC. Contrary to existing literature, postnatal age at NEC presentation was not dependent on gestational age. Detailed review rather than simple definitions are required to separate NEC from FIP.

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