Congenital hypothyroidism with a delayed thyroid-stimulating hormone elevation in very premature infants: incidence and growth and developmental outcomes

J Pediatr. 2011 Apr;158(4):538-42. doi: 10.1016/j.jpeds.2010.10.018. Epub 2011 Jan 13.

Abstract

Objective: To test the hypothesis that very low birth weight (VLBW) and extremely low birth weight (ELBW) infants have an increased incidence of congenital hypothyroidism (CH) with a delayed thyroid-stimulating hormone (TSH) elevation and that the outcomes of these infants are similar to control infants.

Study design: Retrospective analysis of newborn thyroid screening data for 92 800 live births in Rhode Island to identify CH with a delayed TSH elevation. Developmental, growth, and endocrine outcomes of the index cases were assessed at 18 months corrected age.

Results: CH with a delayed TSH elevation occurred in 1 in 58 ELBW, 1 in 95 VLBW, and 1 in 30 329 infants weighing ≥1500 grams (P < .0001). The incidence of head circumference <10(th) percentile was higher in VLBW infants with CH associated with a delayed TSH elevation (P < .05), and the mean head circumferences, weights, lengths, and developmental scores were similar to matched control infants. Three infants received short-term levothyroxine replacement.

Conclusions: The incidence of CH with a delayed TSH elevation was higher in ELBW and VLBW infants compared with infants weighing ≥1500 grams. The outcomes of these infants were comparable with matched control infants.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Congenital Hypothyroidism / blood*
  • Congenital Hypothyroidism / epidemiology*
  • Congenital Hypothyroidism / therapy
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Extremely Low Birth Weight
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases
  • Infant, Very Low Birth Weight* / blood
  • Male
  • Neonatal Screening
  • Thyrotropin / blood*
  • Thyroxine / blood
  • Treatment Outcome

Substances

  • Thyrotropin
  • Thyroxine