Document Detail


Topical iodine-containing antiseptics and neonatal hypothyroidism in very-low-birthweight infants.
MedLine Citation:
PMID:  2570908     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The thyroid function of very-low-birthweight (VLBW; below 1500 g) infants admitted to neonatal intensive-care units was studied at two hospitals; one routinely used topical iodinated antiseptic agents and the other used chlorhexidine-containing antiseptics. Serial monitoring of urinary iodine excretion and serum thyrotropin and thyroxine levels was undertaken from birth for the first 4 weeks of life. Urinary iodine excretion rose dramatically in the 54 iodine-exposed infants and was up to fifty times greater than in the 29 non-exposed infants. Within 14 days, 25% (9 of 36) of the infants exposed to iodine had serum thyrotropin levels above 20 mIU/l, compared with none of the control group. The mean serum thyroxine level in these 9 infants (44.1 nmol/l) was significantly lower than that in exposed infants with normal thyrotropin levels (83.1 nmol/l) and in the non-exposed control group (83.0 nmol/l); thyroxine levels fell before serum thyrotropin rose. These disturbances in thyroid function correlated positively with urinary iodine excretion and hence iodine absorption. Thyroid function had returned to normal by the time of discharge from hospital. It is concluded that iodine absorption, from topical iodine-containing antiseptics, may cause hypothyroidism during a critical period of neurological development in the newborn infant. The routine use of iodine antisepsis in VLBW infants should be avoided because of this effect.
Authors:
P Smerdely; A Lim; S C Boyages; K Waite; D Wu; V Roberts; G Leslie; J Arnold; E John; C J Eastman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Lancet     Volume:  2     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1989 Sep 
Date Detail:
Created Date:  1989-10-18     Completed Date:  1989-10-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  661-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Westmead Hospital, Sydney, Australia.
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MeSH Terms
Descriptor/Qualifier:
Administration, Topical
Anti-Infective Agents, Local / administration & dosage,  adverse effects*,  pharmacokinetics,  urine
Humans
Hypothyroidism / chemically induced*,  metabolism
Infant, Low Birth Weight*
Infant, Newborn
Intensive Care Units, Neonatal
Iodine / administration & dosage,  adverse effects*,  pharmacokinetics,  urine
Prospective Studies
Thyrotropin / blood
Thyroxine / blood
Chemical
Reg. No./Substance:
0/Anti-Infective Agents, Local; 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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