ESPE2023 Poster Category 1 Thyroid (44 abstracts)
National multi-center study of reevaluation of thyroid function in premature infants of less than 32 weeks of gestation and/or less than 1500g admitted to neonatal units
Ariadna Campos-Martorell 1 , Susana Ares Segura 2 , Maria J Chueca Gandulain 3 , Gema Grau Bolado 4 , Constanza Navarro 5 , Loreto Serrano Costa 3 , Ines Gale Pola 3 , Laura Fernandez Vallespin 6 , Laura Pellicer Casanova 6 , Alicia Montaner Ramon 1 , Elisabet Puig Amoros 1 , Marina Mora Sitja 7 , Amparo Rodriguez 7 & Paula Casano-Sancho 6,8
1Vall D'Hebron Hospital, Barcelona, Spain. 2LA Paz Hospital, Madrid, Spain. 3University Hospital of Navarra, Pamplona, Spain. 4Cruces Hospital, Bilbao, Spain. 5Virgen Del Rocio Hospital, Sevilla, Spain. 6Sant Joan De Deu Hospital, Barcelona, Spain. 7Gregorio Marañón Hospital, Madrid, Spain. 8Thyroid Group of Spanish Society for Pediatric Endocrinology, Barcelona, Spain
Preterm and low birth weight(LBW) newborns are at risk of thyroid dysfunction during a critical period for neurodevelpment and this dysfunction can be missed in congenital hypothyroidism screening program(CHSP). Consequently, reassessment of thyroid function has been promoted in neonatal units, added to CHSP.
Objectives: To evaluate prevalence and risk factors of thyroid dysfunction in≤32weeksGA and/or 1500g newborn, and compare different neonatal units protocols.
Methods: Multicenter, retrospective, observational study. Maternal and neonatal data, thyroid function(TSH, free T4(fT4), total T4[tT4]) and CHSP results were retrospectively collected during 2021. Hypothyroxinemia of prematurity(HOP) was defined by fT4<0.8ng/dl and TSH<5mU/L; congenital hypothyroidism(CH) by TSH≥10mU/L and fT4<0.8ng/dl or TSH≥20mU/L regardless of fT4 level and hyperthyrotropinemia was defined as moderate (TSH10-20mU/L) or mild (TSH≥5mU/L), both with normal fT4. All centers performed CHSP with TSH test at 48-72h (2 regions added tT4). Three regions repeated CHSP at 6,15 days and at discharge. Three centers performed venous determination(TSH and fT4) at 2nd week and at discharge, and another two at 4th week and at discharge. Levothyroxine was started according to international recommendations.
Results: 657 neonates from 7 spanish hospitals were evaluated. Median(IQR-interquartile range) of GA and weight and height at birth: 30(4)weeks,1217.5(528)g and 38(5.5)cm. 130(20%) were SGA(Small for Gestational Age). Thyroid dysfunction were found in 161 patients(24%): 8 patients with CH; 22 with moderate hyperthyrotropinemia; 94 with mild hyperthyrotropinemia and 37 with HOP. Twenty-three(3.5%) received oral levothyroxine(8 for CH, 6 for moderate hyperthyrotropinemia and 9 for HOP). Four patients were diagnosed by CHSP, but 4 were false negatives. The majority(92%) of thyroid disorders were transient, with normal thyroid function at discharge. Fifteen(2.7%) infants still were receiving levothyroxine at discharge. Median(IQR) duration of treatment 9.2(14)months. Hyperthyrotropinemia showed statistically association with being SGA(P=0.02), receiving intrapartum antibiotics(P=0.03) and being dead(P=0.04). Hypothyroxinemia showed statistically association(P<0.0001) with intrapartum actions and being diagnosed with ductus, hyaline membrane disease, sepsis, grade IV intraventricular hemorrhage, and maternal thyroid pathology.
Conclusion: The prevalence of thyroid dysfunction in this population is high, although the majority are resolved spontaneously. However, some cases may be undiagnosed by CHSP and they would benefit from treatment. For this reason, it is essential to reassess thyroid function and consensuate the most eficient protocol to improve the care of this newborns.
Article tools
My recent searches
My recently viewed abstracts
Authors
ESPE Abstracts
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more