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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 / Toppari, Jorma / Turan, Serap Demircioglu

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Volume 27, Issue 9-10


Maternal factors and complications of preterm birth associated with neonatal thyroid stimulating hormone

Kelli K. Ryckman / Cassandra N. Spracklen / John M. Dagle / Jeffrey C. Murray
Published Online: 2014-05-22 | DOI: https://doi.org/10.1515/jpem-2013-0366


Thyroid hormones are important regulators of fetal neurodevelopment. Among preterm infants, thyroid stimulating hormone (TSH) is highly variable. Understanding this variability will further improvements in screening for thyroid disorders in preterm infants. We examined 61 maternal and infant clinical and demographic factors for associations with neonatal TSH levels in 698 preterm neonates. TSH was measured as part of routine State-mandated newborn screening in Iowa. Of the maternal characteristics, nulliparous women (p=8×10–4), women with preeclampsia (p=2×10–3), and those with induced labor (p=3×10–3) had infants with higher TSH levels. TSH levels at the time of newborn screening were associated with respiratory distress syndrome (RDS) (p<0.0001) and sepsis (p=3×10–3). We replicated findings between parity and preeclampsia previously observed in primarily term infants. We also observed strong relationships between neonatal TSH and complications of prematurity including RDS and sepsis, which have implications for future studies examining this relationship both prenatally and longitudinally after birth.

Keywords: pregnancy complications; preterm birth; respiratory distress and sepsis; thyroid stimulating hormone (TSH)


  • 1.

    Medici M, de Rijke YB, Peeters RP, Visser W, de Muinck Keizer-Schrama SM, et al. Maternal early pregnancy and newborn thyroid hormone parameters: the generation R study. J Clin Endocrinol Metab 2012;97:646–52.Google Scholar

  • 2.

    Wilson KL, Casey BM, McIntire DD, Halvorson LM, Cunningham FG. Subclinical thyroid disease and the incidence of hypertension in pregnancy. Obstet Gynecol 2012;119:315–20.Web of ScienceGoogle Scholar

  • 3.

    Schneuer FJ, Nassar N, Tasevski V, Morris JM, Roberts CL. Association and predictive accuracy of high TSH serum levels in first trimester and adverse pregnancy outcomes. J Clin Endocrinol Metab 2012;97:3115–22.Web of ScienceGoogle Scholar

  • 4.

    Ryckman KK, Berberich SL, Shchelochkov OA, Cook DE, Murray JC. Clinical and environmental influences on metabolic biomarkers collected for newborn screening. Clin Biochem 2013;46:133–8.PubMedWeb of ScienceCrossrefGoogle Scholar

  • 5.

    Alul FY, Cook DE, Shchelochkov OA, Fleener LG, Berberich SL, et al. The heritability of metabolic profiles in newborn twins. Heredity (Edinb) 2013;110:253–8.Web of ScienceGoogle Scholar

  • 6.

    Tanaka K, Shimizu T, Hosaka A, Tokita A, Shiga S, et al. Serum free T4 and thyroid stimulating hormone levels in preterm infants and relationship between these levels and respiratory distress syndrome. Pediatr Int 2007;49:447–51.Google Scholar

  • 7.

    Herbstman J, Apelberg BJ, Witter FR, Panny S, Goldman LR. Maternal, infant, and delivery factors associated with neonatal thyroid hormone status. Thyroid 2008;18:67–76.Web of SciencePubMedCrossrefGoogle Scholar

  • 8.

    Wilker RE, Fleischman AR, Saenger P, Pan C, Surks MI. Thyroid hormone levels in diabetic mothers and their neonates. Am J Perinatol 1984;1:259–62.Google Scholar

  • 9.

    Ward LS, Kunii IS, de Barros Maciel RM. Thyroid stimulating hormone levels in cord blood are not influenced by non-thyroidal mothers’ diseases. Sao Paulo Med J 2000;118:144–7.Google Scholar

  • 10.

    Sullivan KM, May W, Nordenberg D, Houston R, Maberly GF. Use of thyroid stimulating hormone testing in newborns to identify iodine deficiency. J Nutr 1997;127:55–8.Google Scholar

  • 11.

    Franklin R, O’Grady C, Carpenter L. Neonatal thyroid function: comparison between breast-fed and bottle-fed infants. J Pediatr 1985;106:124–6.Google Scholar

  • 12.

    Chan LY, Chiu PY, Lau TK. Cord blood thyroid-stimulating hormone level in high-risk pregnancies. Eur J Obstet Gynecol Reprod Biol 2003;108:142–5.Google Scholar

  • 13.

    Lao TT, Lee CP. Gestational diabetes mellitus and neonatal hyperthyrotropinemia. Gynecol Obstet Invest 2002;53:135–9.CrossrefPubMedGoogle Scholar

  • 14.

    Hitchcock KR. Lung development and the pulmonary surfactant system: hormonal influences. Anat Rec 1980;198:13–34.Google Scholar

  • 15.

    Hitchcock KR. Hormones and the lung. I. Thyroid hormones and glucocorticoids in lung development. Anat Rec 1979;194:15–39.Google Scholar

  • 16.

    Wilson M, Hitchcock KR, Douglas WH, DeLellis RA. Hormones and the lung. II. Immunohistochemical localization of thyroid hormone binding in type II pulmonary epithelial cells clonally-derived from adult rat lung. Anat Rec 1979;195:611–9.Google Scholar

  • 17.

    van Wassenaer AG, Kok JH, Dekker FW, de Vijlder JJ. Thyroid function in very preterm infants: influences of gestational age and disease. Pediatr Res 1997;42:604–9.Google Scholar

  • 18.

    Klein RZ, Carlton EL, Faix JD, Frank JE, Hermos RJ, et al. Thyroid function in very low birth weight infants. Clin Endocrinol (Oxf) 1997;47:411–7.CrossrefGoogle Scholar

  • 19.

    Cuestas RA, Lindall A, Engel RR. Low thyroid hormones and respiratory-distress syndrome of the newborn. Studies on cord blood. N Engl J Med 1976;295:297–302.Google Scholar

  • 20.

    Cuestas RA, Engel RR. Thyroid function in preterm infants with respiratory distress syndrome. J Pediatr 1979;94:643–6.Google Scholar

  • 21.

    Steffen KM, Cooper ME, Shi M, Caprau D, Simhan HN, et al. Maternal and fetal variation in genes of cholesterol metabolism is associated with preterm delivery. J Perinatol 2007;27:672–80.PubMedCrossrefWeb of ScienceGoogle Scholar

  • 22.

    Ehn NL, Cooper ME, Orr K, Shi M, Johnson MK, et al. Evaluation of fetal and maternal genetic variation in the progesterone receptor gene for contributions to preterm birth. Pediatr Res 2007;62:630–5.Web of ScienceGoogle Scholar

  • 23.

    Simpson J, Williams FL, Delahunty C, van Toor H, Wu SY, et al. Serum thyroid hormones in preterm infants and relationships to indices of severity of intercurrent illness. J Clin Endocrinol Metab 2005;90:1271–9.Google Scholar

  • 24.

    Ng SM, Wong SC, Paize F, Chakkarapani E, Newland P, et al. Multivariate analyses of factors that affect neonatal screening thyroid stimulating hormone. J Pediatr Endocrinol Metab 2011;24:727–32.Web of SciencePubMedGoogle Scholar

  • 25.

    Korada M, Pearce MS, Avis E, Turner S, Cheetham T. TSH levels in relation to gestation, birth weight and sex. Horm Res 2009;72:120–3.Web of ScienceGoogle Scholar

  • 26.

    Dokumov SI, Milanov SC, Trepetshov SP. Thyroid-stimulating hormone in serum of mother and newborn at birth. J Obstet Gynaecol Br Commonw 1971;78:809–11.Google Scholar

  • 27.

    Belet N, Imdat H, Yanik F, Kucukoduk S. Thyroid function tests in preterm infants born to preeclamptic mothers with placental insufficiency. J Pediatr Endocrinol Metab 2003;16:1131–5.PubMedGoogle Scholar

  • 28.

    Narin N, Kurtoglu S, Basbug M, Caksen H, Kafali M, et al. Thyroid function tests in the newborn infants of preeclamptic women. J Pediatr Endocrinol Metab 1999;12:69–73.PubMedGoogle Scholar

  • 29.

    Faber J, Kirkegaard C, Rasmussen B, Westh H, Busch-Sorensen M, et al. Pituitary-thyroid axis in critical illness. J Clin Endocrinol Metab 1987;65:315–20.Google Scholar

  • 30.

    Mitchell IM, Pollock JC, Jamieson MP, Donaghey SF, Paton RD, et al. The effects of cardiopulmonary bypass on thyroid function in infants weighing less than five kilograms. J Thorac Cardiovasc Surg 1992;103:800–5.Google Scholar

  • 31.

    Murzi B, Iervasi G, Masini S, Moschetti R, Vanini V, et al. Thyroid hormones homeostasis in pediatric patients during and after cardiopulmonary bypass. Ann Thorac Surg 1995;59:481–5.CrossrefPubMedGoogle Scholar

  • 32.

    Van den Berghe G, de Zegher F, Lauwers P. Dopamine suppresses pituitary function in infants and children. Crit Care Med 1994;22:1747–53.Google Scholar

  • 33.

    Collaborative trial of prenatal thyrotropin-releasing hormone and corticosteroids for prevention of respiratory distress syndrome. Collaborative Santiago Surfactant Group. Am J Obstet Gynecol 1998;178:33–9.Google Scholar

  • 34.

    Fisch RO, Bilek MK, Miller LD, Engel RR. Physical and mental status at 4 years of age of survivors of the respiratory distress syndrome. Follow-up report from the collaborative study. J Pediatr 1975;86:497–503.Google Scholar

  • 35.

    Crump C, Winkleby MA, Sundquist J, Sundquist K. Preterm birth and risk of medically treated hypothyroidism in young adulthood. Clin Endocrinol (Oxf) 2011;75:255–60.Web of ScienceGoogle Scholar

  • 36.

    Yildizdas D, Onenli-Mungan N, Yapicioglu H, Topaloglu AK, Sertdemir Y, et al. Thyroid hormone levels and their relationship to survival in children with bacterial sepsis and septic shock. J Pediatr Endocrinol Metab 2004;17:1435–42.PubMedGoogle Scholar

  • 37.

    den Brinker M, Joosten KF, Visser TJ, Hop WC, de Rijke YB, et al. Euthyroid sick syndrome in meningococcal sepsis: the impact of peripheral thyroid hormone metabolism and binding proteins. J Clin Endocrinol Metab 2005;90:5613–20.Google Scholar

  • 38.

    den Brinker M, Dumas B, Visser TJ, Hop WC, Hazelzet JA, et al. Thyroid function and outcome in children who survived meningococcal septic shock. Intensive Care Med 2005;31:970–6.CrossrefGoogle Scholar

  • 39.

    Das BK, Agarwal P, Agarwal JK, Mishra OP. Serum cortisol and thyroid hormone levels in neonates with sepsis. Indian J Pediatr 2002;69:663–5.Google Scholar

  • 40.

    Williams F, Hume R. The measurement, definition, aetiology and clinical consequences of neonatal transient hypothyroxinaemia. Ann Clin Biochem 2011;48:7–22.Web of ScienceCrossrefPubMedGoogle Scholar

About the article

Corresponding author: Kelli K. Ryckman, PhD, Assistant Professor, Department of Epidemiology, College of Public Health, University of Iowa, 105 River St, S414 CPHB, Iowa City, IA 52242, USA, Phone: +319-384-1546, E-mail:

Received: 2013-09-10

Accepted: 2014-04-22

Published Online: 2014-05-22

Published in Print: 2014-09-20

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 27, Issue 9-10, Pages 929–938, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2013-0366.

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