Department of Neonatology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098, Istanbul, Turkey.
Department of Pediatric Endocrinology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa, Fatih, 34098, Istanbul, Turkey.
BMC Pediatr. 2021 Aug 14;21(1):344. doi: 10.1186/s12887-021-02826-6.
Hypothyroxinemia is defined by low levels of thyroxine (T4) despite low or normal levels of thyroid-stimulating hormone (TSH). This study aimed to evaluate the factors associated with transient hypothyroxinemia of prematurity (THOP) in newborns admitted to the neonatal intensive care unit (NICU).
This is a single center, retrospective, case-control study. Premature newborns, between 24 and 34 weeks of gestation, hospitalised between January 2014-December 2019 in Istanbul University-Cerrahpasa Faculty of Medicine NICU were analyzed through their medical records. Thyroid function tests were routinely performed between the 10th and 20th days of postnatal life and were evaluated according to the gestational age references. Thirty six possible associated factors (prenatal and postnatal parameters, medical treatments, clinical diagnoses and applications in NICU) were searched in the patient group with THOP (n = 71) and the control group with euthyroid prematures (n = 73). The factors for THOP were identified by univariate analysis, followed by multivariate analysis.
Mean gestational ages of the study and the control groups were 29.7 ± 2.48 and 30.5 ± 2.30 weeks, respectively (p = 0.606). The birth weight, small for gestational age (SGA), intraventricular hemorrhage (IVH), congenital heart disease (CHD) were found to be the possible associated factors for THOP in the univariate analysis and CHD (p = 0.007, odds ratio [OR]:4.9, 95% confidence interval [CI]: 1.5-15.8), BW (p = 0.004, OR:0.999, 95% CI: 0.9-1.0) and SGA (p = 0.010, OR:4.6, 95% CI: 1.4-14.7) were found to be factors associated with THOP determined by univariate logistic regression analysis. CONCLUSıONS: Although some treatment practices might have had direct effects on pituitary-thyroid axis, related with the severity of the newborn clinical conditions, non of them was found to be a associated factor for THOP. However, CHD and SGA may be considered as associated factors with THOP detected in preterm infants.
尽管促甲状腺激素（TSH）水平低或正常，但甲状腺素（T4）水平低定义为甲状腺功能减退症。本研究旨在评估新生儿重症监护病房（NICU）入院的早产儿短暂性甲状腺功能减退症（THOP）的相关因素。
这是一项单中心、回顾性病例对照研究。分析了 2014 年 1 月至 2019 年 12 月在伊斯坦布尔大学切拉哈普萨医学院 NICU 住院的 24 至 34 周早产儿的病历。甲状腺功能测试通常在出生后第 10 至 20 天进行，并根据胎龄参考值进行评估。在 THOP 患者组（n=71）和甲状腺功能正常的早产儿对照组（n=73）中，共搜索了 36 个可能的相关因素（产前和产后参数、治疗方法、临床诊断和 NICU 应用）。通过单因素分析确定 THOP 的因素，然后进行多因素分析。
研究组和对照组的平均胎龄分别为 29.7±2.48 周和 30.5±2.30 周（p=0.606）。单因素分析发现，出生体重、小于胎龄儿（SGA）、脑室出血（IVH）、先天性心脏病（CHD）可能是 THOP 的相关因素，CHD（p=0.007，比值比[OR]：4.9，95%置信区间[CI]：1.5-15.8）、BW（p=0.004，OR：0.999，95% CI：0.9-1.0）和 SGA（p=0.010，OR：4.6，95% CI：1.4-14.7）为单因素 logistic 回归分析确定的与 THOP 相关的因素。结论：尽管一些治疗方法可能对垂体-甲状腺轴有直接影响，与新生儿临床情况的严重程度有关，但没有一种方法被认为是 THOP 的相关因素。然而，CHD 和 SGA 可被视为早产儿 THOP 的相关因素。
