Ares Segura Susana, Casano-Sancho Paula, Chueca Guindulain María
Servicio de Neonatología, Hospital Universitario La Paz, Madrid, España.
Sección de Endocrinología Pediátrica, Institut de Recerca Pediàtrica, Hospital Sant Joan de Déu, Universidad de Barcelona, CIBER de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, España.
An Pediatr (Engl Ed). 2021 May 8. doi: 10.1016/j.anpedi.2021.04.004.
The screening program or early detection of congenital hypothyroidism is one of the greatest advances achieved in Pediatrics. Thyroid hormones are essential for brain development and maturation, which continue into the neonatal stage. Alterations in thyroid function in premature and underweight children in the first months of life causes irreversible damage to the central nervous system and is one of the most frequent and avoidable causes of mental retardation. Diagnosis in the neonatal period is difficult, so it requires an analytical study to be able to carry out the appropriate treatment. The relevance of this problem justifies its communication to all areas of pediatrics. The main objective is to avoid brain damage in these patients. Other aspects to optimize the adequate development of these children with all the necessary periodic controls and to achieve the inclusion of the diagnosis of thyroid alterations during the stay in neonatal units and in the first months of life, need to implement the resources of the health centers and continue advancing according to current knowledge. In this document, we will focus on the screening of preterm newborns VLBW (<32 weeks of gestation) and/or very low weight for gestational age (1500-1000g VLBW or <1000g) and the function evaluation protocol thyroid in premature babies. We update the diagnostic procedures, the essential and complementary tests required, the etiology and the differential diagnoses in this pathology.
先天性甲状腺功能减退症的筛查计划或早期检测是儿科学取得的最重大进展之一。甲状腺激素对大脑发育和成熟至关重要,这种发育和成熟会持续到新生儿期。早产和低体重儿童在出生后的头几个月甲状腺功能异常会对中枢神经系统造成不可逆转的损害,这是智力发育迟缓最常见且可避免的原因之一。新生儿期的诊断很困难,因此需要进行分析研究以便能够实施适当的治疗。这个问题的重要性使其与儿科学的各个领域都相关。主要目标是避免这些患者出现脑损伤。为了通过所有必要的定期检查来优化这些儿童的充分发育,并在新生儿病房住院期间和出生后的头几个月实现甲状腺功能异常的诊断,需要利用健康中心的资源并根据当前知识不断推进。在本文件中,我们将重点关注极低出生体重早产儿(孕周<32周)和/或小于胎龄极低体重儿(1500 - 1000g极低出生体重儿或<1000g)的筛查以及早产儿甲状腺功能评估方案。我们更新了诊断程序、所需的基本和补充检查、该病症的病因及鉴别诊断。