Document Detail

Plasma thyroid hormones in premature infants: effect of gestational age and antenatal thyrotropin-releasing hormone treatment. TRH Collaborative Trial Participants.
MedLine Citation:
PMID:  9803444     Owner:  NLM     Status:  MEDLINE    
Thyroid hormones are important for both perinatal adaptation and long-term psychomotor development; however, there is limited information on the effects of extreme prematurity and antenatal TSH-releasing hormone (TRH) treatment on pituitary-thyroid function. In this study we assayed plasma triiodothyronine (T3) and TSH in infants who were part of a collaborative trial of antenatal maternal TRH therapy. Within the control population (n = 166), infants of 24-28-wk and 28-32-wk gestational age had comparable levels of T3 (0.94 and 1.06 nmol/L, respectively) and TSH (5.7 and 7.2 mU/L) at birth, but the increases at 2 h and subsequent T3 levels were less in the 24-28 wk versus 28-32-wk gestation infants. In the TRH-treated group (n = 131), T3 was lower in the first day for infants delivered 7-72 h after antenatal TRH compared with control infants. TSH at birth was approximately 3.5-fold greater for infants delivered at 0-6 h after the last TRH dose compared with the control group and was suppressed in infants delivering at 7-36 h. T3 and TSH levels were not different between control and TRH-treated groups at 3-28 d of age. In TRH stimulation tests on d 28, control and TRH-treated groups had similar peak levels of TSH and incidence of exaggerated response (TSH > or = 35 mU/L). We conclude that extremely premature infants have a reduced postnatal surge in TSH and T3 and maintain lower T3 concentrations, probably reflecting tertiary hypothyroidism. The stimulatory and suppressive effects of antenatal TRH treatment observed at birth are transient and do not affect pituitary-thyroid responsiveness at 28 d of age.
P L Ballard; R A Ballard; Y Ning; A Cnann; C Boardman; J Pinto-Martin; D Polk; R H Phibbs; D J Davis; F L Mannino; M Hart
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Pediatric research     Volume:  44     ISSN:  0031-3998     ISO Abbreviation:  Pediatr. Res.     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1999-01-12     Completed Date:  1999-01-12     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  642-9     Citation Subset:  IM    
Department of Pediatrics, University of Pennsylvania, Philadelphia 19104, USA.
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MeSH Terms
Congenital Hypothyroidism*
Gestational Age*
Hypothyroidism / drug therapy
Infant, Newborn
Infant, Premature / blood*
Infant, Premature, Diseases / drug therapy*
Prenatal Diagnosis
Thyroid Hormones / blood*
Thyrotropin / blood
Thyrotropin-Releasing Hormone / therapeutic use*
Triiodothyronine / blood
Grant Support
Reg. No./Substance:
0/Thyroid Hormones; 24305-27-9/Thyrotropin-Releasing Hormone; 6893-02-3/Triiodothyronine; 9002-71-5/Thyrotropin

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