This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Paul, D. A.
Right arrow Articles by Bartoshesky, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Paul, D. A.
Right arrow Articles by Bartoshesky, L.
Related Collections
Right arrow Premature & Newborn

PEDIATRICS Vol. 101 No. 5 May 1998, pp. 903-907

Low Serum Thyroxine on Initial Newborn Screening Is Associated With Intraventricular Hemorrhage and Death in Very Low Birth Weight Infants

Received Nov 18, 1997; accepted Jan 2, 1998.

David A. Paul*, Dagger , Kathleen H. Leef*, John L. Stefano*, Dagger , and Louis Bartoshesky*, §, Dagger

From the Sections of * Neonatology and § Medical Genetics, Department of Pediatrics, Christiana Care Health System, Newark, Delaware, and the Dagger  Department of Pediatrics, Thomas Jefferson Medical College, Philadelphia, Pennsylvania.

Transient hypothyroxinemia (TH) of prematurity has been correlated with poor neurodevelopmental outcome. However, the relationship between thyroid function and neonatal mortality and brain injury has not been described.

Objective.  To investigate the relationship between thyroid function and neonatal outcome.

Methods.  Review of infants weighing <1500 grams admitted to a single level III newborn intensive care unit (n = 342). Serum total T4 values of initial newborn screening of infants dying before hospital discharge were compared with those of surviving infants. Total T4 values from infants with and without intraventricular hemorrhage (IVH) and periventricular leukomalacia (PVL) also were compared.

Results.  T4 values strongly correlated with gestational age (r = .56). Overall, 289 (85%) of 342 infants had TH. None of the infants had true congenital hypothyroidism. T4 values of infants with cystic PVL (n = 15) were not statistically different from those for infants who did not develop cystic PVL. Infants with IVH (n = 58) had a lower T4 value than did infants who did not develop IVH (5.4 ± 3.4 µg/dL vs 7.8 ± 3.6 µg/dL). Infants who died before hospital discharge (n = 24) had a lower T4 value than did infants discharged to home (3.4 ± 2.2 vs 7.9 ± 3.7 µg/dL). After controlling for potential confounding variables, T4 value remained associated with an increased odds of IVH (odds ratio: 1.2; 95% confidence interval: 1.05 to 1.4) and mortality (odds ratio: 2.3; 95% confidence interval 1.6 to 3.4).

Conclusions.  In our population of very low birth weight infants, TH has an incidence of 85%. Very low T4 values on initial newborn screening are associated with increased odds of death and IVH. Additional investigation is needed to determine whether low serum thyroxine level contributes to IVH and neonatal death or whether it is simply an associated factor.

Key words: thyroxine, mortality, intraventricular hemorrhage, prematurity.




This article has been cited by other articles:


Home page
 NeoReviewsHome page
N. Forghani and T. Aye
Hypothyroxinemia and Prematurity
NeoReviews, February 1, 2008; 9(2): e66 - e71.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
F. L. R. Williams, S. A. Ogston, H. van Toor, T. J. Visser, R. Hume, and with collaboration from the Scottish Preterm Thyro
Serum Thyroid Hormones in Preterm Infants: Associations with Postnatal Illnesses and Drug Usage
J. Clin. Endocrinol. Metab., November 1, 2005; 90(11): 5954 - 5963.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
D. J. Lim, M. K. Herring, K. H. Leef, J. Getchell, L. E. Bartoshesky, and D. A. Paul
Hypothyroxinemia in Mechanically Ventilated Term Infants Is Associated With Increased Use of Rescue Therapies
Pediatrics, February 1, 2005; 115(2): 406 - 410.
[Abstract] [Full Text] [PDF]

Home page
 NeoReviewsHome page
L. R. Blackmon
Biologic Limits of Viability: Implications for Clinical Decision-making
NeoReviews, June 1, 2003; 4(6): e140 - 146.
[Full Text] [PDF]

Home page
 Arch Pediatr Adolesc MedHome page
D. A. Paul, M. M. Coleman, K. H. Leef, D. Tuttle, and J. L. Stefano
Maternal Antibiotics and Decreased Periventricular Leukomalacia in Very Low-Birth-Weight Infants
Arch Pediatr Adolesc Med, February 1, 2003; 157(2): 145 - 149.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
A L Ogilvy-Stuart
Neonatal thyroid disorders
Arch. Dis. Child. Fetal Neonatal Ed., November 1, 2002; 87(3): F165 - 171.
[Abstract] [Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
D. A. Paul, K. H. Leef, J. L. Stefano, and L. Bartoshesky
Thyroid Function in Very-Low-Birth-Weight Infants with Intraventricular Hemorrhage
Clinical Pediatrics, November 1, 2000; 39(11): 651 - 656.
[Abstract] [PDF]

Home page
 NeoReviewsHome page
A. G. van Wassenaer and J. H. Kok
Thyroid Function and Thyroid Hormone Requirements of Very Preterm Infants
NeoReviews, June 1, 2000; 1(6): e116 - 121.
[Full Text]

Home page
 PediatricsHome page
J. Dembinski;, D. A. Paul, K. H. Leff, J. L. Stefano, and L. Bartoshesky
Thyroid Function and Adverse Outcome---What Is the Message?
Pediatrics, July 1, 1999; 104(1): 129 - 129.
[Full Text]