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The prevalence of hypothyroxinemia in premature newborns

Congenital hypothyroidism diagnosed by TSH assessment in bloodspot screening may be overlooked in preterm newborns due to immaturity of the hypothalamus-pituitary-thyroid axis in them. The purpose of the study was to determine the prevalence and causes of hypothyroxinemia in preterm newborns, determ...

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Autores principales: Stawerska, Renata, Nowak-Bednarek, Marzena, Talar, Tomasz, Kolasa-Kicińska, Marzena, Łupińska, Anna, Hilczer, Maciej, Gulczyńska, Ewa, Lewiński, Andrzej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9399394/
https://www.ncbi.nlm.nih.gov/pubmed/36034431
http://dx.doi.org/10.3389/fendo.2022.940152
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author Stawerska, Renata
Nowak-Bednarek, Marzena
Talar, Tomasz
Kolasa-Kicińska, Marzena
Łupińska, Anna
Hilczer, Maciej
Gulczyńska, Ewa
Lewiński, Andrzej
author_facet Stawerska, Renata
Nowak-Bednarek, Marzena
Talar, Tomasz
Kolasa-Kicińska, Marzena
Łupińska, Anna
Hilczer, Maciej
Gulczyńska, Ewa
Lewiński, Andrzej
author_sort Stawerska, Renata
collection PubMed
description Congenital hypothyroidism diagnosed by TSH assessment in bloodspot screening may be overlooked in preterm newborns due to immaturity of the hypothalamus-pituitary-thyroid axis in them. The purpose of the study was to determine the prevalence and causes of hypothyroxinemia in preterm newborns, determined by TSH and FT4 serum concentration measurement, performed on the 3-5(th) day of life. We assessed TSH, FT4 and FT3 serum concentration on the 3-5(th) day of life in preterm children born at our centre within three consecutive years. We assessed the incidence of hypothyroxinemia, and its cause: primary hypothyroidism, secondary hypothyroidism or low FT4 syndrome - with normal TSH concentration, its dependence - among others - on gestational age (GA), birth body weight (BBW) and being SGA. A total of 525 preterm children were examined. FT4 concentration was decreased in 14.9% of preterm newborns. The most frequent cause of hypothyroxinemia was low FT4 syndrome (79.5%). More than 92% cases of hypothyroxinemia occurred in children born before the 32(nd) week and/or with BBW below 1500 g. Thus, every fourth child in these groups had a reduced FT4 concentration. Neonates with hypothyroxinemia were significantly lighter than those with normal FT4. In older and heavier neonates with hypothyroxinemia, serious congenital defects were observed. Neither IVH nor SGA nor twin pregnancies predispose children to hypothyroxinemia. Among newborns with untreated hypothyroxinemia in whom TSH and FT4 assessment was repeated within 2-5 weeks, a decreased FT4 concentration was confirmed in 56.1% of cases. As hypothyroxinemia affects 25% of newborns born before the 32(nd) week of gestation and those in whom BBW is less than 1500g, it seems that in this group of children the newborn screening should be extended to measure serum TSH and FT4 concentration between the 3-5(th) day of life. In older and heavier neonates, additional serum TSH and FT4 assessment should be limited to children with severe congenital abnormalities but not to all SGA or twins. Despite the fact that the most common form of preterm hypothyroxinemia is low FT4 syndrome, it should be emphasized that FT4 remains lowered on subsequent testing in more them 50% of cases.
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spelling pubmed-93993942022-08-25 The prevalence of hypothyroxinemia in premature newborns Stawerska, Renata Nowak-Bednarek, Marzena Talar, Tomasz Kolasa-Kicińska, Marzena Łupińska, Anna Hilczer, Maciej Gulczyńska, Ewa Lewiński, Andrzej Front Endocrinol (Lausanne) Endocrinology Congenital hypothyroidism diagnosed by TSH assessment in bloodspot screening may be overlooked in preterm newborns due to immaturity of the hypothalamus-pituitary-thyroid axis in them. The purpose of the study was to determine the prevalence and causes of hypothyroxinemia in preterm newborns, determined by TSH and FT4 serum concentration measurement, performed on the 3-5(th) day of life. We assessed TSH, FT4 and FT3 serum concentration on the 3-5(th) day of life in preterm children born at our centre within three consecutive years. We assessed the incidence of hypothyroxinemia, and its cause: primary hypothyroidism, secondary hypothyroidism or low FT4 syndrome - with normal TSH concentration, its dependence - among others - on gestational age (GA), birth body weight (BBW) and being SGA. A total of 525 preterm children were examined. FT4 concentration was decreased in 14.9% of preterm newborns. The most frequent cause of hypothyroxinemia was low FT4 syndrome (79.5%). More than 92% cases of hypothyroxinemia occurred in children born before the 32(nd) week and/or with BBW below 1500 g. Thus, every fourth child in these groups had a reduced FT4 concentration. Neonates with hypothyroxinemia were significantly lighter than those with normal FT4. In older and heavier neonates with hypothyroxinemia, serious congenital defects were observed. Neither IVH nor SGA nor twin pregnancies predispose children to hypothyroxinemia. Among newborns with untreated hypothyroxinemia in whom TSH and FT4 assessment was repeated within 2-5 weeks, a decreased FT4 concentration was confirmed in 56.1% of cases. As hypothyroxinemia affects 25% of newborns born before the 32(nd) week of gestation and those in whom BBW is less than 1500g, it seems that in this group of children the newborn screening should be extended to measure serum TSH and FT4 concentration between the 3-5(th) day of life. In older and heavier neonates, additional serum TSH and FT4 assessment should be limited to children with severe congenital abnormalities but not to all SGA or twins. Despite the fact that the most common form of preterm hypothyroxinemia is low FT4 syndrome, it should be emphasized that FT4 remains lowered on subsequent testing in more them 50% of cases. Frontiers Media S.A. 2022-08-10 /pmc/articles/PMC9399394/ /pubmed/36034431 http://dx.doi.org/10.3389/fendo.2022.940152 Text en Copyright © 2022 Stawerska, Nowak-Bednarek, Talar, Kolasa-Kicińska, Łupińska, Hilczer, Gulczyńska and Lewiński https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Stawerska, Renata
Nowak-Bednarek, Marzena
Talar, Tomasz
Kolasa-Kicińska, Marzena
Łupińska, Anna
Hilczer, Maciej
Gulczyńska, Ewa
Lewiński, Andrzej
The prevalence of hypothyroxinemia in premature newborns
title The prevalence of hypothyroxinemia in premature newborns
title_full The prevalence of hypothyroxinemia in premature newborns
title_fullStr The prevalence of hypothyroxinemia in premature newborns
title_full_unstemmed The prevalence of hypothyroxinemia in premature newborns
title_short The prevalence of hypothyroxinemia in premature newborns
title_sort prevalence of hypothyroxinemia in premature newborns
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9399394/
https://www.ncbi.nlm.nih.gov/pubmed/36034431
http://dx.doi.org/10.3389/fendo.2022.940152
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