Biomaterial Database

Congenital hypothyroidism with delayed thyroid-stimulating hormone elevation in premature infants born at less than 30 weeks gestation. 2017

D C Kaluarachchi, and T T Colaizy, and L M Pesce, and M Tansey, and J M Klein

Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City, IA, USA.

Congenital hypothyroidism (CH) with delayed thyroid-stimulating hormone (TSH) elevation is a common form of thyroid dysfunction among premature infants. Routine newborn screening (NBS) may miss infants with CH with delayed TSH elevation. The objective of the study is to determine the prevalence of CH with delayed TSH elevation in premature infants and to identify associated risk factors. Retrospective analysis of serum thyroid function screening (TFS) at day of life 30 in premature infants <30 weeks gestation, admitted to University of Iowa Neonatal Intensive Care Unit between 1 July 2012 to 30 June 2015. Serum free thyroxine and TSH levels were obtained in premature infants <30 weeks gestation on day of life 30. Follow-up testing and pediatric endocrinology consultation were done according to the institutional protocol. In total, 286 infants were included. All infants underwent routine NBS and 280 patients underwent TFS. Twenty-six patients (9.1%) were diagnosed with thyroid dysfunction. NBS identified only three patients. CH with delayed TSH elevation was diagnosed in 20 patients (6.9%) and was significantly associated with multiple gestation, lower birth weight, higher gestational age and lower 5 min APGAR score. Thyroid dysfunction is common among premature infants born before 30 weeks gestation. The majority of cases with thyroid dysfunction had CH with delayed TSH elevation, which was not detected by NBS. We recommend measurement of serum TSH and free T4 levels on day of life 30 in premature infants born at <30 weeks gestation to identify patients with CH with delayed TSH elevation.

UI	MeSH Term	Description	Entries
D007223	Infant	A child between 1 and 23 months of age.	Infants
D007231	Infant, Newborn	An infant during the first 28 days after birth.	Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007234	Infant, Premature	A human infant born before 37 weeks of GESTATION.	Neonatal Prematurity,Premature Infants,Preterm Infants,Infant, Preterm,Infants, Premature,Infants, Preterm,Premature Infant,Prematurity, Neonatal,Preterm Infant
D007363	Intensive Care Units, Neonatal	Hospital units providing continuing surveillance and care to acutely ill newborn infants.	Neonatal Intensive Care Unit,Neonatal Intensive Care Units,Newborn Intensive Care Unit,Newborn Intensive Care Units,ICU, Neonatal,Neonatal ICU,Newborn ICU,Newborn Intensive Care Units (NICU),ICU, Newborn,ICUs, Neonatal,ICUs, Newborn,Neonatal ICUs,Newborn ICUs
D007484	Iowa	State bounded on the north by Minnesota, on the east by Wisconsin and Illinois, on the south by Missouri, and on the west by Nebraska and South Dakota.
D008297	Male		Males
D001724	Birth Weight	The mass or quantity of heaviness of an individual at BIRTH. It is expressed by units of pounds or kilograms.	Birthweight,Birth Weights,Birthweights,Weight, Birth,Weights, Birth
D003409	Congenital Hypothyroidism	A condition in infancy or early childhood due to an in-utero deficiency of THYROID HORMONES that can be caused by genetic or environmental factors, such as thyroid dysgenesis or HYPOTHYROIDISM in infants of mothers treated with THIOURACIL during pregnancy. Endemic cretinism is the result of iodine deficiency. Clinical symptoms include severe MENTAL RETARDATION, impaired skeletal development, short stature, and MYXEDEMA.	Cretinism,Myxedema, Congenital,Endemic Cretinism,Fetal Iodine Deficiency Disorder,Cretinism, Endemic,Hypothyroidism, Congenital
D005260	Female		Females
D005865	Gestational Age	The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated from the onset of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization. It is also estimated to begin from fertilization, estrus, coitus, or artificial insemination.	Embryologic Age,Fetal Maturity, Chronologic,Chronologic Fetal Maturity,Fetal Age,Maturity, Chronologic Fetal,Age, Embryologic,Age, Fetal,Age, Gestational,Ages, Embryologic,Ages, Fetal,Ages, Gestational,Embryologic Ages,Fetal Ages,Gestational Ages