Document Detail


Levels of neonatal thyroid hormone in preterm infants and neurodevelopmental outcome at 5 1/2 years: millennium cohort study.
MedLine Citation:
PMID:  20719832     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Transient hypothyroxinemia is the commonest thyroid dysfunction of premature infants, and recent studies have found adverse associations with neurodevelopment. The validity of these associations is unclear because the studies adjusted for a differing range of factors likely to influence neurodevelopment.
OBJECTIVE: The aim was to describe the association of transient hypothyroxinemia with neurodevelopment at 5.5 yr corrected age.
DESIGN: We conducted a follow-up study of a cohort of infants born in Scotland from 1999 to 2001 ≤34 wk gestation.
MAIN OUTCOME MEASURES: We measured scores on the McCarthy scale adjusted for 26 influences of neurodevelopment including parental intellect, home environment, breast or formula fed, growth retardation, and use of postnatal drugs.
RESULTS: A total of 442 infants ≤34 wk gestation who had serum T(4) measurements on postnatal d 7, 14, or 28 and 100 term infants who had serum T(4) measured in cord blood were followed up at 5.5 yr. Infants with hypothyroxinemia (T(4) level ≤ 10th percentile on d 7, 14, or 28 corrected for gestational age) scored significantly lower than euthyroid infants (T(4) level greater than the 10th percentile and less than the 90th percentile on all days) on all McCarthy scales, except the quantitative. After adjustment for confounders of neurodevelopment, hypothyroxinemic infants scored significantly lower than euthyroid infants on the general cognitive and verbal scales.
CONCLUSIONS: Our findings do not support the view that the hypothyroxinemic state, in the context of this analysis, is harmless in preterm infants. Many factors contribute both to the etiology of hypothyroxinemia and neurodevelopment; strategies for correction of hypothyroxinemia should acknowledge its complex etiology and not rely solely on one approach.
Authors:
Caroline Delahunty; Shona Falconer; Robert Hume; Lesley Jackson; Paula Midgley; Marie Mirfield; Simon Ogston; Oliver Perra; Judith Simpson; Jennifer Watson; Peter Willatts; Fiona Williams;
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-18
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  95     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-05     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4898-908     Citation Subset:  AIM; IM    
Affiliation:
Wishaw General Hospital, Wishaw, Scotland, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Brain / physiopathology
Child Development / physiology*
Child, Preschool
Cognition / physiology*
Cohort Studies
Developmental Disabilities / blood*,  physiopathology
Follow-Up Studies
Humans
Hypothyroidism / blood*
Infant, Newborn
Infant, Premature
Intelligence / physiology
Scotland
Thyroxine / blood*
Grant Support
ID/Acronym/Agency:
//Chief Scientist Office
Chemical
Reg. No./Substance:
7488-70-2/Thyroxine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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