Document Detail


Low serum thyroxine on initial newborn screening is associated with intraventricular hemorrhage and death in very low birth weight infants.
MedLine Citation:
PMID:  9565423     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Transient hypothyroxinemia (TH) of prematurity has been correlated with poor neurodevelopmental outcome. However, the relationship between thyroid function and neonatal mortality and brain injury has not been described. OBJECTIVE: To investigate the relationship between thyroid function and neonatal outcome. METHODS: Review of infants weighing <1500 grams admitted to a single level III newborn intensive care unit (n = 342). Serum total T4 values of initial newborn screening of infants dying before hospital discharge were compared with those of surviving infants. Total T4 values from infants with and without intraventricular hemorrhage (IVH) and periventricular leukomalacia (PVL) also were compared. RESULTS: T4 values strongly correlated with gestational age (r = .56). Overall, 289 (85%) of 342 infants had TH. None of the infants had true congenital hypothyroidism. T4 values of infants with cystic PVL (n = 15) were not statistically different from those for infants who did not develop cystic PVL. Infants with IVH (n = 58) had a lower T4 value than did infants who did not develop IVH (5.4 +/- 3.4 microg/dL vs 7.8 +/- 3.6 microg/dL). Infants who died before hospital discharge (n = 24) had a lower T4 value than did infants discharged to home (3.4 +/- 2.2 vs 7.9 +/- 3.7 microg/dL). After controlling for potential confounding variables, T4 value remained associated with an increased odds of IVH (odds ratio: 1.2; 95% confidence interval: 1.05 to 1.4) and mortality (odds ratio: 2.3; 95% confidence interval 1.6 to 3.4). CONCLUSIONS: In our population of very low birth weight infants, TH has an incidence of 85%. Very low T4 values on initial newborn screening are associated with increased odds of death and IVH. Additional investigation is needed to determine whether low serum thyroxine level contributes to IVH and neonatal death or whether it is simply an associated factor.
Authors:
D A Paul; K H Leef; J L Stefano; L Bartoshesky
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pediatrics     Volume:  101     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  1998 May 
Date Detail:
Created Date:  1998-05-20     Completed Date:  1998-05-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  903-7     Citation Subset:  AIM; IM    
Affiliation:
Section of Neonatology, Department of Pediatrics, Christiana Care Health System, Newark, Delaware 19718, USA.
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MeSH Terms
Descriptor/Qualifier:
Cerebral Hemorrhage / epidemiology*
Hospital Mortality
Humans
Infant Mortality*
Infant, Newborn
Infant, Premature / blood
Infant, Very Low Birth Weight / blood*
Leukomalacia, Periventricular / epidemiology
Multivariate Analysis
Neonatal Screening
Odds Ratio
Risk Factors
Thyrotropin / blood
Thyroxine / blood*
Chemical
Reg. No./Substance:
7488-70-2/Thyroxine; 9002-71-5/Thyrotropin
Comments/Corrections
Comment In:
Pediatrics. 1999 Jul;104(1 Pt 1):129-30   [PMID:  10419398 ]

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