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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Ogata, Tsutomu / Toppari, Jorma

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2191-0251
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Volume 26, Issue 5-6

Issues

Thyroid dysfunctions of prematurity and their impacts on neurodevelopmental outcome1)

Mi Lim Chung
  • Department of Pediatrics, College of Medicine, Inje University, Haeundae Paik Hospital, Busan, Seoul, Cheonju
  • Other articles by this author:
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/ Han Wok Yoo
  • Division of Endocrinology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children’s Hospital, Busan, Seoul, Cheonju
  • Other articles by this author:
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/ Ki-Soo Kim
  • Division of Neonatology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children’s Hospital, Busan, Seoul, Cheonju
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/ Byong Sop Lee
  • Division of Neonatology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children’s Hospital, Busan, Seoul, Cheonju
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/ Soo-Young Pi
  • Division of Neonatology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children’s Hospital, Busan, Seoul, Cheonju
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/ Gina Lim
  • Department of Pediatrics, College of Medicine, Chungbuk National University, Chungbuk Hospital, Busan, Seoul, Cheonju
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/ Ellen Ai-Rhan Kim
  • Corresponding author
  • Division of Neonatology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center Children’s Hospital, Busan, Seoul, Cheonju
  • Email
  • Other articles by this author:
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Published Online: 2013-02-15 | DOI: https://doi.org/10.1515/jpem-2012-0332

Abstract

Background: Thyroid dysfunction is very common and is associated with neurodevelopmental impairments in preterm infants.

Objectives: This study was conducted to determine the incidence and natural course of various thyroid dysfunctions and their impacts on neurodevelopmental outcomes among premature infants.

Methods: A total of 177 infants were enrolled who were born at <34 weeks or whose birth weight was <1500 g and who underwent repeat thyroid function tests. We analyzed how various thyroid dysfunctions affected neurodevelopmental outcomes at 18 months of corrected age.

Results: Thyroid dysfunction was noted in 88 infants. Hypothyroxinemia was observed in 23 infants, and their thyroid function was influenced by variable clinical factors. Free T4 levels were all normalized without thyroxine medication, and neurodevelopmental outcomes were not affected. In contrast, hyperthyrotropinemia was not associated with other clinical factors. Among 58 subjects who had hyperthyrotropinemia, only 31 infants showed normal thyroid-stimulating hormone (TSH) levels at follow-up tests. The remaining 27 infants had persistently high TSH levels, which significantly and poorly influenced the neurodevelopmental outcomes.

Conclusions: Thyroid dysfunction is common among preterm infants. With the exception of persistent hyperthyrotropinemia, it generally does not affect neurodevelopmental outcomes. However, the beneficial effects of thyroid hormone therapy in patients with persistent hyperthyrotropinemia merits further study.

Keywords: neurodevelopmental outcome; thyroid dysfunction; very low birth weight infants

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About the article

Corresponding author: Ellen Ai-Rhan Kim, MD, Division of Neonatology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, 86, Asan Byung Won Gil, Song-pa Gu, Busan, Seoul 138-736, Cheonju, Phone: +82 2 3010 3390, Fax: +81 2 3010 6978


Received: 2012-10-17

Accepted: 2012-12-22

Published Online: 2013-02-15

Published in Print: 2013-05-01


This study was approved by the institutional review board of Asan Medical Center, which obtained official certification from the WHO-affiliated Forum for Ethical Review Committees in Asia and the Western Pacific.


Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 26, Issue 5-6, Pages 449–455, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2012-0332.

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