Published online October 17, 2005
PEDIATRICS Vol. 116 No. 5 November 2005, pp. e613-e618 (doi:10.1542/peds.2005-0876)
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ELECTRONIC ARTICLE

Ten-Year Follow-up of Children Born at <30 Weeks’ Gestational Age Supplemented With Thyroxine in the Neonatal Period in a Randomized, Controlled Trial

Aleid G. van Wassenaer, MD, PhD, Jolanda Westera, MSc, Bregje A. Houtzager, PhD and Joke H. Kok, MD, PhD

From the Department of Neonatology, Emma Children’s Hospital Academic Medical Center, Amsterdam, the Netherlands

Background. Thyroid hormones are essential for brain development. We conducted a randomized, controlled trial with thyroxine (T4) supplementation in infants <30 weeks’ gestation and with the last neurodevelopmental follow-up moment at the age of 5.5 years. T4 supplementation was associated with improved outcome of infants <28 weeks’ gestation and worse outcome of infants of 29 weeks’ gestation. We studied gestational age–dependent effects of T4 supplementation at the mean age of 10.5 years in children participating in our randomized, controlled trial.

Methods. Questionnaires regarding school outcome, behavior, quality of life, motor problems, and parental stress were sent to the parents and children and their teachers at the same time point for all surviving children (9–12 years of age).

Results. Seventy-two percent of the families responded to our questionnaires. Nonrespondents had more sociodemographic risk factors and worse development until 5.5 years. At the mean age of 10.5 years, T4 supplementation was associated with better school outcome in those who were <27 weeks’ gestation and better motor outcome in those who were <28 weeks’ gestation, whereas the reverse was true for those who were born at 29 weeks’ gestation. No other gestational age–dependent outcomes were found.

Conclusions. Gestation-dependent effects of T4 supplementation remain stable over time. These effects do not prove beneficial effects of T4 in infants <28 weeks but should be the background for a new randomized, controlled trial with thyroid hormone in this age group.

Key Words: premature infants • psychomotor development • randomized • controlled trial • school performance • thyroid function

Abbreviations: T4, thyroxine • T3, triiodothyronine • FT4, free thyroxine • ABC, Assessment Battery for Children • CBCL, Child Behavior Checklist

Accepted Jun 13, 2005.


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