Servicio de Neonatología, Hospital Universitario La Paz, Madrid, Spain.
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, Spain.
An Pediatr (Engl Ed). 2021 Oct;95(4):277.e1-277.e8. doi: 10.1016/j.anpede.2021.04.003. Epub 2021 Sep 15.
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 (1500-1000 g VLBW or <1000 g) 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或早期检测是儿科学取得的最大进展之一。甲状腺激素对大脑发育和成熟至关重要，这一过程一直持续到新生儿期。早产儿和低出生体重儿在生命的头几个月甲状腺功能的改变会对中枢神经系统造成不可逆转的损害，是智力障碍最常见且可预防的原因之一。新生儿期的诊断较为困难，因此需要进行分析性研究以进行适当的治疗。该问题的重要性使得有必要向儿科学的各个领域进行交流。其主要目标是避免这些患者的脑损伤。为了优化这些儿童的适当发育，还需要进行其他方面的工作，包括进行所有必要的定期检查，并实现对新生儿病房和生命最初几个月期间甲状腺功能改变的诊断，这需要利用卫生中心的资源并根据现有知识不断推进。在本文件中，我们将重点介绍对极低出生体重儿（VLBW）(<32 周胎龄)和/或小于胎龄儿（VLBW 体重 1500-1000g 或<1000g）的早产儿进行筛查以及对早产儿甲状腺功能的评估方案。我们更新了该病理的诊断程序、所需的基本和补充检查、病因和鉴别诊断。
