Thyroid function in preterm infants and neurodevelopment at 2 years
ObjectivesPostnatal thyroid dysfunction is common in preterm infants but the relationship between mild dysfunction and neurodevelopment is unclear. Our aim is to describe the relationship between thyroid function and neurodevelopment.DesignCohort analysis.Patients1275 infants born under 31 weeks’ ge...
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Published in | Archives of disease in childhood. Fetal and neonatal edition Vol. 105; no. 5; pp. 504 - 509 |
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Abstract | ObjectivesPostnatal thyroid dysfunction is common in preterm infants but the relationship between mild dysfunction and neurodevelopment is unclear. Our aim is to describe the relationship between thyroid function and neurodevelopment.DesignCohort analysis.Patients1275 infants born under 31 weeks’ gestation; there were no exclusion criteria.SettingThe infants were part of a UK daily iodine supplementation trial.Main outcomesThyroid-stimulating hormone, thyroid-binding globulin and total thyroxine levels were measured in dried blood spots on postnatal days 7, 14, 28 and the equivalent of 34 weeks’ gestation. Neurodevelopment was measured using the Bayley-III Scales of infant development at 2 years of age.ResultsNo infant was identified as hypothyroid through routine screening. The 3% of infants consistently in the top decile of gestationally age-adjusted thyroid-stimulating hormone levels had a reduction in cognitive score of 7 Bayley units when compared with those not in the top decile (95% CI –13 to –1). A reduction in motor composite score of 6 units (95% CI −12 to <−0.1) and fine motor score of 1 unit (95% CI –2 to –0.1) was also identified. The 0.7% of infants consistently in the bottom decile of age-adjusted thyroxine levels had a reduction in motor composite score of 14 units (95% CI –25 to –2) and its two subset scores, fine and gross motor, of 2 units (95% CI respectively −4.5 to <−0.1 and –4.3 to –0.3).ConclusionsPreterm infants with consistent ‘mild’ thyroid dysfunction score less on neurodevelopmental tests at 2 years of age. Many of these infants will not be detected by current clinical protocols or screening programmes. |
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AbstractList | ObjectivesPostnatal thyroid dysfunction is common in preterm infants but the relationship between mild dysfunction and neurodevelopment is unclear. Our aim is to describe the relationship between thyroid function and neurodevelopment.DesignCohort analysis.Patients1275 infants born under 31 weeks’ gestation; there were no exclusion criteria.SettingThe infants were part of a UK daily iodine supplementation trial.Main outcomesThyroid-stimulating hormone, thyroid-binding globulin and total thyroxine levels were measured in dried blood spots on postnatal days 7, 14, 28 and the equivalent of 34 weeks’ gestation. Neurodevelopment was measured using the Bayley-III Scales of infant development at 2 years of age.ResultsNo infant was identified as hypothyroid through routine screening. The 3% of infants consistently in the top decile of gestationally age-adjusted thyroid-stimulating hormone levels had a reduction in cognitive score of 7 Bayley units when compared with those not in the top decile (95% CI –13 to –1). A reduction in motor composite score of 6 units (95% CI −12 to <−0.1) and fine motor score of 1 unit (95% CI –2 to –0.1) was also identified. The 0.7% of infants consistently in the bottom decile of age-adjusted thyroxine levels had a reduction in motor composite score of 14 units (95% CI –25 to –2) and its two subset scores, fine and gross motor, of 2 units (95% CI respectively −4.5 to <−0.1 and –4.3 to –0.3).ConclusionsPreterm infants with consistent ‘mild’ thyroid dysfunction score less on neurodevelopmental tests at 2 years of age. Many of these infants will not be detected by current clinical protocols or screening programmes. OBJECTIVESPostnatal thyroid dysfunction is common in preterm infants but the relationship between mild dysfunction and neurodevelopment is unclear. Our aim is to describe the relationship between thyroid function and neurodevelopment. DESIGNCohort analysis. PATIENTS1275 infants born under 31 weeks' gestation; there were no exclusion criteria. SETTINGThe infants were part of a UK daily iodine supplementation trial. MAIN OUTCOMESThyroid-stimulating hormone, thyroid-binding globulin and total thyroxine levels were measured in dried blood spots on postnatal days 7, 14, 28 and the equivalent of 34 weeks' gestation. Neurodevelopment was measured using the Bayley-III Scales of infant development at 2 years of age. RESULTSNo infant was identified as hypothyroid through routine screening. The 3% of infants consistently in the top decile of gestationally age-adjusted thyroid-stimulating hormone levels had a reduction in cognitive score of 7 Bayley units when compared with those not in the top decile (95% CI -13 to -1). A reduction in motor composite score of 6 units (95% CI -12 to <-0.1) and fine motor score of 1 unit (95% CI -2 to -0.1) was also identified. The 0.7% of infants consistently in the bottom decile of age-adjusted thyroxine levels had a reduction in motor composite score of 14 units (95% CI -25 to -2) and its two subset scores, fine and gross motor, of 2 units (95% CI respectively -4.5 to <-0.1 and -4.3 to -0.3). CONCLUSIONSPreterm infants with consistent 'mild' thyroid dysfunction score less on neurodevelopmental tests at 2 years of age. Many of these infants will not be detected by current clinical protocols or screening programmes. Postnatal thyroid dysfunction is common in preterm infants but the relationship between mild dysfunction and neurodevelopment is unclear. Our aim is to describe the relationship between thyroid function and neurodevelopment. Cohort analysis. 1275 infants born under 31 weeks' gestation; there were no exclusion criteria. The infants were part of a UK daily iodine supplementation trial. Thyroid-stimulating hormone, thyroid-binding globulin and total thyroxine levels were measured in dried blood spots on postnatal days 7, 14, 28 and the equivalent of 34 weeks' gestation. Neurodevelopment was measured using the Bayley-III Scales of infant development at 2 years of age. No infant was identified as hypothyroid through routine screening. The 3% of infants consistently in the top decile of gestationally age-adjusted thyroid-stimulating hormone levels had a reduction in cognitive score of 7 Bayley units when compared with those not in the top decile (95% CI -13 to -1). A reduction in motor composite score of 6 units (95% CI -12 to <-0.1) and fine motor score of 1 unit (95% CI -2 to -0.1) was also identified. The 0.7% of infants consistently in the bottom decile of age-adjusted thyroxine levels had a reduction in motor composite score of 14 units (95% CI -25 to -2) and its two subset scores, fine and gross motor, of 2 units (95% CI respectively -4.5 to <-0.1 and -4.3 to -0.3). Preterm infants with consistent 'mild' thyroid dysfunction score less on neurodevelopmental tests at 2 years of age. Many of these infants will not be detected by current clinical protocols or screening programmes. |
Author | Cheetham, Timothy Boelen, Anita Watson, Jennifer Williams, Fiona L R Lindgren, Alice |
Author_xml | – sequence: 1 givenname: Fiona L R surname: Williams fullname: Williams, Fiona L R email: f.l.r.williams@dundee.ac.uk organization: Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, UK – sequence: 2 givenname: Alice surname: Lindgren fullname: Lindgren, Alice email: f.l.r.williams@dundee.ac.uk organization: Medical Student, Medical School, Ninewells Hospital and Medical School, Dundee, UK – sequence: 3 givenname: Jennifer surname: Watson fullname: Watson, Jennifer email: f.l.r.williams@dundee.ac.uk organization: Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, UK – sequence: 4 givenname: Anita surname: Boelen fullname: Boelen, Anita email: f.l.r.williams@dundee.ac.uk organization: Neonatal Screening Laboratory, Laboratory of Endocrinology, Academic Medical Centre, Amsterdam, The Netherlands – sequence: 5 givenname: Timothy surname: Cheetham fullname: Cheetham, Timothy email: f.l.r.williams@dundee.ac.uk organization: Department of Paediatric Endocrinology, Institute of Human Genetics, Newcastle upon Tyne, UK |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32079615$$D View this record in MEDLINE/PubMed |
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Snippet | ObjectivesPostnatal thyroid dysfunction is common in preterm infants but the relationship between mild dysfunction and neurodevelopment is unclear. Our aim is... Postnatal thyroid dysfunction is common in preterm infants but the relationship between mild dysfunction and neurodevelopment is unclear. Our aim is to... OBJECTIVESPostnatal thyroid dysfunction is common in preterm infants but the relationship between mild dysfunction and neurodevelopment is unclear. Our aim is... |
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SubjectTerms | Babies Gestational age Hypothyroidism Infants Iodine Laboratories Newborn babies Nursing care Pediatrics Premature babies Premature birth Thyroid Thyroid gland |
Title | Thyroid function in preterm infants and neurodevelopment at 2 years |
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