Lee Gahyun, Park So Yun, Park Jae Hyun, Kang Seokjin
Department of Pediatrics, Keimyung University Dongsan Hospital, Daegu, Korea.
Department of Pediatrics, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea, Daegu, Korea.
Ann Pediatr Endocrinol Metab. 2023 Mar;28(1):42-48. doi: 10.6065/apem.2244002.001. Epub 2022 Jun 28.
Recent reports indicate that small for gestational age (SGA) could be a risk factor for delayed thyroid stimulating hormone (dTSH) elevation in preterm infants. The development of dTSH elevation in SGA late-preterm infants with a gestational age of 34-36 weeks has been investigated in only a few studies.
In the present retrospective study, 70 SGA infants and 86 sex- and gestational age-matched controls who presented with normal results on initial thyroid function testing were included.
SGA infants had a significantly higher prevalence of dTSH elevation (15.7% vs. 3.5%, P=0.009) compared with appropriate-for-gestational age infants. In SGA infants, the mean age at the time of dTSH was 24 days. Development of dTSH was associated with SGA and medical treatment with dopamine or furosemide. After adjusting for confounding factors, multiple logistic regression analysis showed SGA was a significant risk factor for the development of dTSH elevation (odds ratio, 23.2; 95% confidence interval, 2.27-236.91; P=0.008).
SGA infants may be at risk for dTSH and clinicians could consider a second thyroid screening test around the age of 1 month.
近期报告表明，小于胎龄（SGA）可能是早产儿促甲状腺激素（dTSH）升高延迟的一个风险因素。仅少数研究对胎龄为34 - 36周的SGA晚期早产儿中dTSH升高的情况进行了调查。
在本回顾性研究中，纳入了70例SGA婴儿以及86例性别和胎龄匹配的对照，这些婴儿初次甲状腺功能检测结果均正常。
与适于胎龄的婴儿相比，SGA婴儿中dTSH升高的患病率显著更高（15.7%对3.5%，P = 0.009）。在SGA婴儿中，出现dTSH时的平均年龄为24天。dTSH的出现与SGA以及多巴胺或呋塞米治疗有关。在对混杂因素进行校正后，多因素逻辑回归分析显示SGA是dTSH升高发生的一个显著风险因素（比值比，23.2；95%置信区间，2.27 - 236.91；P = 0.008）。
SGA婴儿可能存在dTSH风险，临床医生可考虑在1月龄左右进行第二次甲状腺筛查。
