Thyroid-stimulating hormone levels in the first days of life and perinatal factors associated with sub-optimal neuromotor outcome in pre-term infants

J Endocrinol Invest. 2011 Nov;34(10):e308-13. doi: 10.3275/7795. Epub 2011 Jun 7.


Aim: To identify perinatal factors associated with sub-optimal neuromotor outcome in infants without evident central nervous system lesions (intraventricular hemorrhage/ periventricular leukomalacia), with gestational age ≤30 (group I) and of 31-32 weeks (group II).

Patients and methods: A total of 102 premature infants admitted to the Neonatal Intensive Care Unit of Pisa, at 26-32 weeks of gestation, were studied. Data about perinatal factors and TSH values at 3-4 days of life were collected. The assessment of neuromotor development was performed at 18 months of corrected age, using the locomotor subscale of the Griffiths Scales of Mental Development.

Results: Risk factors supposed to be predictive of sub-optimal neuromotor outcome (odds ratio >1) were at ≤30 weeks: male sex, small for gestational age, patent duct arterious, respiratory distress syndrome, and at 31-32 weeks: Apgar at 5 min <7, respiratory distress syndrome, patent duct arterious and birth weight <1500 g. A strong correlation was also found between TSH screening values >4,3 mU/l and suboptimal neuromotor outcome in both groups.

Conclusions: Several perinatal factors, acting on an immature and more vulnerable nervous system, such as the pre-term one, different for different gestational ages, are associated with a sub-optimal neuromotor outcome. Higher, but within the normal range, TSH values at screening seem to be a strong risk factor for neuromotor outcome in preterm infants without intraventricular hemorrhage or periventricular leukomalacia.

MeSH terms

  • Developmental Disabilities / blood
  • Developmental Disabilities / etiology
  • Ductus Arteriosus, Patent / complications
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Intensive Care Units, Neonatal
  • Iodine / deficiency
  • Leukomalacia, Periventricular / complications
  • Male
  • Pregnancy
  • Prenatal Exposure Delayed Effects
  • Respiratory Distress Syndrome, Newborn / complications
  • Smoking / adverse effects
  • Thyroid Gland / embryology
  • Thyrotropin / blood*


  • Thyrotropin
  • Iodine