Hypothyroxinemia and Prematurity

Author:

Forghani Nikta1,Aye Tandy1

Affiliation:

1. Division of Endocrinology, Department of Pediatrics, Stanford University, Palo Alto, Calif

Abstract

The growing fetus relies on adequate thyroid hormone concentrations for normal development, which is dependent on maternal transplacental thyroid hormone passage and the appropriate development of the fetal hypothalamic-pituitary-thyroid axis. Untreated congenital hypothyroidism can result in severe neurodevelopmental disabilities, including mental retardation, auditory dysfunction, and spastic diplegia. Most outcomes data also suggest that up to 10% of infants treated early in the era of newborn screening still have long-term disabilities, although they are minor. Preterm infants have lower serum concentrations of thyroid hormones compared with their term counterparts early in postnatal life, and there has been a concern that this transient hypothyroxinemia could be partially responsible for the neurodevelopmental impairment associated with prematurity. Therefore, a number of investigators have examined this relationship and the potential use of thyroid hormone in preterm infants to improve neurodevelopmental outcomes. This article reviews this literature and discusses possible directions for the future.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

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