Document Detail


Routine skin cleansing with povidone-iodine is not a common cause of transient neonatal hypothyroidism in North America: a prospective controlled study.
MedLine Citation:
PMID:  9226209     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
R S Brown; S Bloomfield; F J Bednarek; M L Mitchell; L E Braverman
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  7     ISSN:  1050-7256     ISO Abbreviation:  Thyroid     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-09-17     Completed Date:  1997-09-17     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  395-400     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, University of Massachusetts Medical School and the Medical Center of Central Massachusetts, Worcester 01655, USA.
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MeSH Terms
Descriptor/Qualifier:
Anti-Infective Agents, Local / 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:
AM18919/AM/NIADDK NIH HHS
Chemical
Reg. No./Substance:
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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