Thyroid function in prematures with respiratory distress syndrome (RDS)

1986 ◽  
Vol 113 (4_Suppl) ◽  
pp. S354-S360 ◽  
Author(s):  
N. STAHNKE ◽  
E. STENZEL ◽  
H. HELLWEGE
Keyword(s):  
Longitudinal Study ◽  
Thyroid Hormone ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Thyroid Function ◽  
Gestational Age ◽  
Distress Syndrome ◽  
Normal Range ◽  
Hormone Levels ◽  
Thyroid Hormone Levels

Abstract Reports on thyroid function in newborns with respiratory distress syndrome (RDS) are controversial, the significance of obtained results is not clear. Therefore we conducted a longitudinal study of thyroid function in 35 infants with RDS (gestational age 24-36 weeks, birth weights 65o-277o g). 43 well prematures, matched for gestational age, served as controls. No significant differences were observed in cord blood TSH, T3, T4, TBG values and T4:TBG ratios between infants with and without RDS. Prematures with RDS showed lower levels of T3, T4, TBG and T4:TBG at 24 hours of age and increases of TSH values at 72 hours. Subsequently these prematures exhibited a spontaneous rise in thyroid hormone levels. Even non-surviving RDS-infants had initial T3, T4, T4:TBG and TSH values within the normal range. Thyroid hormone concentrations correlated significantly with the severity of pulmonary disease. Depressed thyroid hormone levels were found to be the result and not the cause of RDS. T4 or T3 therapy is not warranted in this condition.

scholarly journals Association between Thyroid Stimulating Hormone and Respiratory Distress Syndrome of Newborn in the Preterm Infants

2020 ◽  
Author(s):  
Young Jin Kim ◽  
Byoung Kook Kim ◽  
Yong Hyuk Kim
Keyword(s):  
Thyroid Hormone ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Distress Syndrome ◽  
Control Group ◽  
Lower Serum ◽  
Significant Difference ◽  
Serum Tsh ◽  
Tsh Levels

Abstract Background: Various hormones are known to influence the production and secretion of pulmonary surfactant. But the relationship between respiratory distress syndrome (RDS) and thyroid hormone has yet to be clarified. Methods: 126 infants with gestational age between 24 and 34 weeks who were hospitalized at the neonatal ICU of the Wonju Severance Christian Hospital from April 2017 to February 2019 were included in the study. Infants were divided into 3 groups by gestational age – 24 weeks 0 days to 28 weeks 0 days, 28 weeks 0 days to 31 weeks 0 days, and 31 weeks 0 days to 33 weeks 0 days, each with 18, 34, and 74 subjects, respectively. Among the subjects, there were 56 infants with RDS and 70 infants without RDS.Results: The group with lowest gestational age showed T3 and fT4 level that was lower than those of other groups (p<0.05) on the day of birth but there was no difference in the TSH level (p=0.129). T3 and TSH level were lower in the RDS group compared with the control group on the day of birth (p<0.05). Free thyroxine (fT4) level was higher in the control group on the day of birth but without any significant difference. Multiple logistic regression analysis showed that lower serum TSH levels on the day of birth was associated with a higher incidence of RDS (p<0.05).Conclusion: The incidence of RDS was significantly higher in infants with lower serum TSH levels at birth, but there was no significant difference in RDS incidence according to serum thyroid hormone levels.

scholarly journals Small for Gestational Age is a Risk Factor for Thyroid Dysfunction in Preterm Newborns

2020 ◽  
Author(s):  
Chunhua Liu ◽  
Kaiyan Wang ◽  
Jizhong Guo ◽  
Jiru Chen ◽  
Mei Chen ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Thyroid Dysfunction ◽  
Z Score ◽  
Normal Range ◽  
Free Triiodothyronine ◽  
Hormone Levels ◽  
Thyroid Hormone Levels ◽  
Altered Thyroid

Abstract Background Thyroid hormones play an important role in the normal growth and maturation of the central nervous system. However, few publications addressed the altered thyroid hormone levels in preterm small for gestational age (SGA) newborns. We hypothesized preterm SGA infants have higher thyroid-stimulating hormone (TSH) concentrations than appropriate for gestational age (AGA) ones within the normal range and an increased incidence of thyroid dysfunction. Methods The study was designed to compare thyroid hormone levels within the normal range and the incidence of thyroid dysfunction in the SGA and AGA groups to test the hypothesis. Blood samples were collected between 72 and 96 hours of life and analyzed with TSH, free thyroxine (FT4) and free triiodothyronine (FT3) assays. Thyroid function test (TFT) results, and neonatal demographic and clinical factors were analyzed to identify the associations between SGA birth and altered thyroid concentrations and thyroid dysfunction. Results TSH and FT4 concentrations were significantly higher in the SGA group than the AGA group ((4.89(interquartile range (IQR): 2.62~7.59) vs. 3.15(IQR: 1.86~5.42) mU/L, p=0.015), and (18.64±4.39 vs. 17.40±3.70 pmol/L, p=0.037), respectively). The higher TSH levels were associated with being SGA or Z-score of birth weight (BW) for GA after adjusting for potential confounders (( β SGA =1.28 (95% confidence interval (CI) 0.45~2.12), p=0.003) or ( β Z-score =-0.25 (95%CI -0.48~-0.03), p=0.028), respectively). However, we did not find a significant association between SGA birth and altered FT4 concentrations. Furthermore, compared with the AGA group, the SGA group presented an increased incidence of transient hypothyroxinemia with delayed TSH elevation (dTSHe) (odds ratio (OR) =8.75(95%CI 0.71~78.02)), a higher percentage receiving levothyroxine (L-T4) therapy (OR=1.80 (95%CI 0.98~3.21)), and a higher rate of follow-up within the first 6 months of life (OR=1.82 (95%CI 0.93~3.39)). Conclusions Preterm SGA newborns had significantly higher TSH concentrations within the normal range and an increased incidence of thyroid dysfunction. The SGA newborns with these features should be closely followed up with periodical TFTs and endocrinologic evaluation.

scholarly journals Small for Gestational Age is a Risk Factor for Thyroid Dysfunction in Preterm Newborns

2020 ◽  
Author(s):  
Chunhua Liu(Former Corresponding Author) ◽  
Kaiyan Wang ◽  
Jizhong Guo ◽  
Jiru Chen ◽  
Mei Chen ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Thyroid Dysfunction ◽  
Z Score ◽  
Normal Range ◽  
Free Triiodothyronine ◽  
Hormone Levels ◽  
Thyroid Hormone Levels ◽  
Altered Thyroid

Abstract Background : Thyroid hormones play an important role in the normal growth and maturation of the central nervous system. However, few publications addressed the altered thyroid hormone levels in preterm small for gestational age (SGA) newborns. We hypothesized preterm SGA infants have higher thyroid-stimulating hormone (TSH) concentrations than appropriate for gestational age (AGA) ones within the normal range and an increased incidence of thyroid dysfunction. Methods : The study was designed to compare thyroid hormone levels within the normal range and the incidence of thyroid dysfunction in the SGA and AGA groups to test the hypothesis. The medical records of all preterm infants admitted to the neonatal intensive care unit (NICU) at the First Affiliated Hospital of Shantou University Medical College, Shantou, China, between January 1, 2015 and December 31, 2018, were reviewed. Blood samples were collected between 72 and 96 hours of life and analyzed with TSH, free thyroxine (FT4) and free triiodothyronine (FT3) assays. Thyroid function test (TFT) results, and neonatal demographic and clinical factors were analyzed to identify the associations between SGA birth and altered thyroid concentrations and thyroid dysfunction. Results : TSH and FT4 concentrations were significantly higher in the SGA group than the AGA group ((3.74(interquartile range (IQR):2.28~6.18) vs. 3.01(IQR: 1.81~5.41) mU/L, p=0.018), and (17.76±3.94 vs. 17.42±3.71 pmol/L, p=0.371), respectively). The higher TSH levels were associated with being SGA or Z-score of birth weight (BW) for GA after adjusting for potential confounders (( β SGA =0.68 (95% confidence interval (CI) 0.15~1.21), p=0.013) or ( β Z-score =-0.25 (95%CI -0.48~-0.03), p=0.028), respectively). However, we did not find a significant association between SGA birth and altered FT4 concentrations. Furthermore, compared with the AGA group, the SGA group presented an increased incidence of transient hypothyroxinemia with delayed TSH elevation (dTSHe), a higher percentage receiving levothyroxine (L-T4) therapy, and a higher rate of follow-up within the first 6 months of life. Conclusions : Preterm SGA newborns had significantly higher TSH concentrations within the normal range and an increased incidence of thyroid dysfunction. The SGA newborns with these features should be closely followed up with periodical TFTs and endocrinologic evaluation.

Thyroid Function in Respiratory Distress Syndrome (RDS) of the Newborn

PEDIATRICS ◽  
1974 ◽  
Vol 54 (4) ◽  
pp. 423-428
Author(s):  
Ralph A. Redding ◽  
Celina Pereira
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Thyroid Function ◽  
Gestational Age ◽  
Distress Syndrome ◽  
Newborn Infants ◽  
Free Thyroxine ◽  
Total Serum ◽  
Serum Thyroxine ◽  
Free Thyroxine Index

Preliminary evaluation of thyroid function, utilizing total serum thyroxine (T4) and triiodothyronine (T3) resin uptake, was assessed following delivery in three groups of babies and their respective mothers; 40 premature new-borns with respiratory distress syndrome (RDS), 39 prematures comparable by gestational age who failed to develop RDS, and 22 full-term normal babies. The group of premature newborn infants in whom RDS occurred, as compared to the other two groups, had significantly lower mean total serum thyroxine levels and "free thyroxine index" (T4 x %T3 uptake/100). When matched by gestational age, the differences were also significant. Two days following delivery, the total serum T4 in the surviving prematures with RDS as compared to prematures without RDS was also significantly lower. The mean values for total T4 and "free thyroxine index" in the respective mothers of the three groups were not significantly different. Since L-thyroxine has been shown to increase the production of lung surfactant, widely accepted as deficient in RDS newborn infants, an association between lung immaturity and fetal thyroid function is postulated.

scholarly journals 1342 CORD BLOOD THYROID FUNCTION STUDIES IN PREMATURE INFANTS WITH AND WITHOUT RESPIRATORY DISTRESS SYNDROME (RDS)

1981 ◽  
Vol 15 ◽  
pp. 667-667
Author(s):  
Alan H Klein ◽  
Barbara Foley ◽  
Thomas P Foley ◽  
Hugh H Macdonald ◽  
Delbert A Fisher
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Cord Blood ◽  
Thyroid Function ◽  
Premature Infants ◽  
Distress Syndrome

MATERNAL AND PERINATAL OUTCOMES WITH ANTENATAL CORTICOSTEROID ADMINISTRATION IN PRETERM DELIVERIES AT GOVERNMENT DISTRICT HOSPITAL, NANDYAL- AN OBSERVATIONAL STUDY

2021 ◽  
pp. 8-14
Author(s):  
P. Swathi ◽  
K. Radhikajyothi
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Distress Syndrome ◽  
District Hospital ◽  
Antenatal Corticosteroid ◽  
Antenatal Corticosteroids ◽  
Corticosteroid Administration ◽  
Antenatal Steroids ◽  
Government District

BACKGROUND: Preterm birth remains a major health issue worldwide. Preterm delivery affects over 7–12% of births in India and is responsible for up to 75% of neonatal deaths. Despite advances in medical technology, the prevalence of preterm birth is increasing. Discovery of antenatal corticosteroid for fetal maturation and its adoption into clinical practice highlights several fascinating and universal truths about science and medicine. The challenge in human studies is to demonstrate antenatal corticosteroid administration in pregnancy contributes to developmental programming and how this is manifested in later life. The World Health Organization recommends the use of one course of antenatal steroids for all pregnant women between 26 and 35 weeks of gestation who are at risk of preterm delivery within 7 days. Both, the American College of Obstetricians and Gynaecologists and the Royal College of Obstetricians and Gynaecologists recommend their use between 24 and 34 weeks of gestation (1). The use of antenatal steroids after 34 or 35 weeks of gestation is not recommended unless there is evidence of fetal pulmonary immaturity. Despite this, antenatal steroids are widely used globally across all gestational periods. In a diverse country like India, diversity in clinical practice is a reality. Hence, the present research study intends to study the maternal and perinatal outcomes with antenatal corticosteroid administration in preterm deliveries at Government district hospital, Nandyal in South India. AIMS AND OBJECTIVES Ÿ To determine the incidence of RDS at District hospital, Nandyal among neonates delivered between 28-37 weeks due to PTL, PPROM or severe PET whose mothers received ACS and in those whose mothers did not receive ACS. Ÿ To determine the severity of RDS at District hospital, Nandyal among neonates delivered between 28-37 weeks due to PTL, PPROM or severe PET whose mothers received ACS and in those whose mothers did not receive ACS. Ÿ To compare the neonatal mortality among neonates delivered between 28-37 weeks due to PTL, PPROM or severe PET whose mothers received ACS with those whose mothers did not receive ACS. Ÿ To determine the effectiveness of antenatal corticosteroid administration in preventing early neonatal respiratory distress syndrome in early preterm labour versus late preterm labour. Ÿ To determine the effectiveness of ACS administration in preventing neonatal complications with respect to the mode of delivery. METHODOLOGY: Study was conducted at Government District Hospital, Nandyal from 01/01/2019 to 30/10/2019. A structured questionnaire was prepared under guidance of thesis guide. All pregnant women with gestational age between 28 completed weeks to 37 completed weeks, presenting in OPD either in labour or getting admitted due to any other maternal medical complication, are initially assessed thoroughly to estimate the gestational age by history, LMP, early USG, and clinical examination. They are given a course of ACS if they were not expecting delivery within next 1 hour, after explaining the benets and risks of ACS as per recommendations of Federation of International st Gynecology and Obstetrics. Those who did not receive ACS or those who delivered within 24hrs of administration of 1 dose of ACS were considered as subjects in NACS group. Those who received ACS were considered as subjects in ACS group. After delivery, the neonate is followed up in NICU until discharged or until 7 days whichever is shorter. Mother is followed up for any clinical signs of infection, until she is discharged. Data is analyzed scientically. RESULTS: In Antenatal corticosteroids group (ACS), there were 36 subjects within 20 years, 43 subjects between 20-25 years, 29 subjects between 25-30 years, 25 subjects between 30-35 years. In No Antenatal corticosteroids group (NACS), there were 32 subjects within 20 years, 49 subjects between 20-25 years, 25 subjects between 25-30 years, 10 subjects between 30-35 years. Study observed that Antenatal corticosteroids group had lower incidence of Respiratory distress syndrome compared to No Antenatal corticosteroids group (12.07% versus 23.28%). Antenatal corticosteroids group had lower incidence of severe Respiratory distress syndrome compared to No Antenatal corticosteroids group (21.3 % versus 33.33%) among those who had Respiratory Distress Syndrome. Antenatal corticosteroids group had fewer admissions to NICU than No Antenatal corticosteroids group (20.69% versus 33.62%). Antenatal corticosteroids group had lower mortality than No Antenatal corticosteroids group (12.07 % versus 22.41%). Antenatal corticosteroids group had 35 % less chances of Respiratory distress syndrome compared to No Antenatal corticosteroids group. In No Antenatal corticosteroids group, subjects who underwent vaginal delivery had 10% less risk compared to those who underwent LSCS for their neonates to have Respiratory distress syndrome. In Antenatal corticosteroids group, subjects who underwent vaginal delivery had 14.29 % less risk compared to those who underwent LSCS for their neonates to have Respiratory distress syndrome. Antenatal corticosteroids group had maternal infection rate comparable to No Antenatal Corticosteroids group. CONCLUSION: Use of antenatal corticosteroids was found to be benecial in pregnant women with Gestational age of 28 completed weeks to less than 37 completed weeks at Government District hospital, Nandyal. Antenatal corticosteroids did not have statistically signicant adverse effects (i.e. increased rate of infection) in mothers.

scholarly journals Morphofunctional features of platelets in premature newborns with very low and extremely low body weight

2021 ◽  
Vol 12 (2) ◽  
pp. 35-41
Author(s):  
Anastasia V. Budalova ◽  
Natalia V. Kharlamova ◽  
Galina N. Kuzmenko
Keyword(s):  
Body Weight ◽  
Platelet Count ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Distress Syndrome ◽  
Premature Newborns ◽  
Intrauterine Growth

Background. Currently, the development of medicine in the field of perinatology is aimed at improving the quality of medical care for newborns, especially those born prematurely. Premature newborns are most likely to develop hemorrhagic disorders, which often aggravates their condition and determines high morbidity and mortality. On modern hematological analyzers, it has become possible to evaluate a larger number of blood parameters, including platelet parameters, however, there are a small number of studies devoted to the study of platelet parameters in premature newborns. The aim was to study the morphofunctional features of platelets in premature newborns with very low and extremely low body weight. Materials and methods. The study included 78 newborns born at 2534 weeks of gestation, with a body weight of less than 1500 grams. On the 3rd5th day of life, a clinical blood test was performed on the Advia 2120i hematological analyzer (Siemens), with the determination of platelet parameters: PLT, 103 cells/l, PCT, %, PDW, %, Large Plt, 103 cells/l, MPC, g/dl, MRM, pg. Results. In newborns with ELBW, a decrease in the number and granularity of platelets in the blood, an increase in the average dry mass of platelets was found. Newborns with intrauterine growth retardation have a reduced platelet count and reduced thrombocrit. In premature newborns with a gestational age of 2527 weeks, blood circulation of platelets with a reduced volume was established, and in newborns who were born at a gestational age of 3234 weeks with increased granularity. In the absence of antenatal prevention of respiratory distress syndrome in newborns, there is a decrease in thrombocrit, the number of platelets, including large forms in the blood. In premature newborns born in a state of severe asphyxia, a decrease in platelet granularity was noted. The use of high concentrations of O2 in the oxygen-air mixture during respiratory therapy leads to a decrease in the number of platelets in the blood. Conclusions. Factors determining the morphofunctional state of platelets in premature newborns were established: the presence of a full course of antenatal prevention of respiratory distress syndrome of newborns, gestational age, the severity of asphyxia at birth, as well as the concentration of O2 in the oxygen-air mixture used in respiratory therapy. Newborns with ELBW have a reduced platelet count, low-granulated platelets, and an increased average dry platelet mass. Newborns with intrauterine growth retardation have a reduced number of platelets and thrombocrit in the blood. The revealed morphofunctional features of platelets allow us to clarify the nature of changes in the platelet link of hemostasis in premature newborns for the timely prevention of complications during the underlying disease.

scholarly journals Serum Thyroid Hormone Levels in Healthy Children from Birth to Adulthood and in Short Children Born Small for Gestational Age

2012 ◽  
Vol 97 (9) ◽  
pp. 3170-3178 ◽  
Author(s):  
Annemieke J. Lem ◽  
Yolanda B. de Rijke ◽  
Hans van Toor ◽  
Maria A. J. de Ridder ◽  
Theo J. Visser ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Healthy Children ◽  
Hormone Levels ◽  
Short Children ◽  
Serum Thyroid Hormone ◽  
Thyroid Hormone Levels
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