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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Milner, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, Marc J.N.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Ogata, Edward / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

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Volume 33, Issue 6 (Dec 2005)


Transient hypothyroxinemia of prematurity and histological chorioamnionitis

Claudio De Felice
  • Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Senese, Italy
/ Franco Bagnoli
  • Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Senese, Italy
/ Paolo Toti
  • Department of Human Pathology and Oncology, University of Siena, Italy
/ Maria Antonietta Musarò
  • Neonatal Screening and Pediatric Endocrinology Laboratory, Department of Obstetrics, Pediatrics and Reproductive Medicine, Azienda Ospedaliera Universitaria Senese, Italy
/ Luana Peruzzi
  • Neonatal Screening and Pediatric Endocrinology Laboratory, Department of Obstetrics, Pediatrics and Reproductive Medicine, Azienda Ospedaliera Universitaria Senese, Italy
/ Patrizia Paffetti
  • Laboratorio di Pediatria Neonatale, Azienda Ospedaliera Universitaria Senese, Italy
/ Giuseppe Latini
  • Perrino Hospital, Brindisi, Italy
Published Online: 2005-12-01 | DOI: https://doi.org/10.1515/JPM.2005.091


Background: Transient hypothyroxinaemia of prematurity (THOP) is a common condition of preterm infants whose causes remain unclear. We tested the hypothesis that THOP is associated with histological chorioamnionitis (HCA).

Methods: Whole blood T4 and TSH concentrations on day 4 and at 40 weeks' postmenstrual age (rtx-T4 and rtx-TSH), placental histology and illness severity were prospectively evaluated in 155 very low birth weight (VLBW) infants.

Results: HCA-positive infants showed significantly decreased blood total T4 concentrations on day 4, as compared to the HCA-negative population (P<0.0001), along with comparable TSH, rtx-T4, and rtx-TSH blood concentrations. None of the infants showed evidence of hypothyroidism during the study. A total T4≤4.4 μg/dL on postnatal day 4 identified HCA-positive newborns with 90.8%, sensitivity, 94.7%, specificity, 96.7% positive predictive and 85.7% negative predictive values. HCA (OR: 32.19; 95% CI: 8.95–115.64), birth weight ≤880 g (OR: 4.1; 1.15–14.64), and RDS (OR: 3.71, 95% CI: 1.13–12.25) were independently associated with evidence of hypothyroxinaemia on day 4.

Conclusion: Our findings indicate a previously un-recognized relationship between HCA and THOP, hence suggesting a predominant role for a fetal systemic inflammatory response syndrome in the pathogenesis of THOP.

Keywords: Chorioamnionitis/diagnosis; congenital hypothyroidism screening; placenta diseases; transient hypothyroxinaemia of prematurity


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About the article

Corresponding author: Giuseppe Latini, MD Perrino Hospital Division of Neonatology s.s. 7 per Mesagne 72100 Brindisi/Italy

Received: April 22, 2005

Revised: July 22, 2005

Accepted: August 9, 2005

Published Online: 2005-12-01

Published in Print: 2005-12-01

Citation Information: Journal of Perinatal Medicine, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: https://doi.org/10.1515/JPM.2005.091. Export Citation

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