ESPE Abstracts

Background: A common cause of neurodevelopmental impairment in children is congenital hypothyroidism, but can be preventable with adequate screening and proper management. Preterm newborns are more likely to have thyroid dysfunction, with small for gestational age (SGA) being an additional risk factor. However, only few studies addressed the altered thyroid hormone concentrations in the first few weeks of life concluding that Thyroid-Stimulating Hormone (TSH) levels are higher in SGA newborns. As a result, we conducted a study to compare thyroid hormone levels and the incidence of thyroid dysfunction between the SGA and the appropriate for gestational age (AGA) infants.

Methods and Materials: This is a cross-sectional retrospective single-centered study conducted at Centre HospitalierUniversitaire Notre Dame des Secours (CHUNDS), Jbeil, Lebanon, between January 1, 2016 and November 31, 2020. The medical records including thyroid function test results, sociodemographic characteristics and clinical conditions of 260 preterm infants admitted to the Neonatal Intensive Care Unit (NICU) were reviewed.

Results: A higher percentage of infants who were SGA had abnormal thyroid function in general (31.8% vs 14.4%, P=0.002), and hyperthyrotropinemia in particular (18.2% vs 6.2%, P=0.004) compared to AGA infants. Moreover, infants who were SGA had significantly higher mean TSH levels compared to those who were AGA (6.86 ± 4.31* vs 4.55 ± 3.22*, P <0.001).

Conclusion: Preterm SGA neonates had higher TSH levels and an increased incidence of thyroid dysfunction. Therefore, close follow up with periodic thyroid function testing, endocrinologicand cognitive assessment is of significant importance in SGA infants presenting these features.