| Routine skin cleansing with povidone-iodine is not a common cause of transient neonatal hypothyroidism in North America: a prospective controlled study. | |
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MedLine Citation:
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PMID: 9226209 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A high incidence of transient neonatal hypothyroidism has been observed in premature infants after routine skin cleansing with iodine. Because these reports have been predominantly from Europe, a borderline, iodine-deficient area, we wished to determine whether this was also true in North America, an iodine-sufficient area. A prospective, controlled study was performed in premature babies < or = 36 weeks gestation admitted to a neonatal intensive care nursery. Thyroxine (T4) and thyrotropin (TSH) were measured at day 1, days 4 to 6, and 10 to 12 after skin preparation with iodine or with a noniodine-containing antiseptic solution (chlorhexidine) that served as control. If repeat cleansing was required, this sequence was repeated. Urinary iodine was quantitated on days 1 to 3 to estimate iodine exposure. There was no difference in the mean T4 concentration at any of the time points evaluated nor in the incidence of transient hypothyroidism between the iodine-exposed (2/17) and control babies (0/14) despite urinary iodine excretion up to 88 times the control value. Unexpectedly 5 iodine-exposed but 0 control babies developed severe hypothyroxinemia (T4 < 40 nmol/L), compatible with the sick euthyroid syndrome; one of them died. We conclude that, unlike in Europe, transient hypothyroidism is not a common sequela of routine skin cleansing with iodine in premature newborn infants in North America. This difference in incidence may be due to prior iodine status. Whether excessive iodine absorption in premature infants is associated with thyroid-independent toxic effects remains to be clarified. |
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Authors:
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R S Brown; S Bloomfield; F J Bednarek; M L Mitchell; L E Braverman |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Thyroid : official journal of the American Thyroid Association Volume: 7 ISSN: 1050-7256 ISO Abbreviation: Thyroid Publication Date: 1997 Jun |
Date Detail:
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Created Date: 1997-09-17 Completed Date: 1997-09-17 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 9104317 Medline TA: Thyroid Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 395-400 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, University of Massachusetts Medical School and the Medical Center of Central Massachusetts, Worcester 01655, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Infective Agents, Local
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adverse effects* Chlorhexidine / adverse effects Disinfection Female Humans Hypothyroidism / chemically induced*, epidemiology, urine Infant, Newborn Iodine / urine Male North America / epidemiology Povidone-Iodine / adverse effects* Prospective Studies Thyrotropin / blood Thyroxine / blood Time Factors |
| Grant Support | |
ID/Acronym/Agency:
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AM18919/AM/NIADDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anti-Infective Agents, Local; 25655-41-8/Povidone-Iodine; 55-56-1/Chlorhexidine; 7488-70-2/Thyroxine; 7553-56-2/Iodine; 9002-71-5/Thyrotropin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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