Mukherjee Debarghya, Mukhopadhyay Pradip, Saha Bijan, Sen Sangita, Ghosh Sujoy
Department of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
Department of Endocrinology and Metabolism, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
Indian J Endocrinol Metab. 2024 May-Jun;28(3):315-319. doi: 10.4103/ijem.ijem_436_23. Epub 2024 Jun 26.
Initial surge of thyroid-stimulating hormone (TSH) in neonates increases free and total triiodothyronine (T3) and tetraiodothyronine (T4) in 24-36 hours following birth, and the effect then gradually wanes off. As somatic and intellectual development is dependent on normal thyroid function especially in infancy, normative data in these children may be of immense value to diagnose hypothyroidism in this subset of infants. Comprehensive normative values of thyroid function parameters in preterm neonates are scarcely available. The objective of this study was to determine the normative value of thyroid function parameters in preterm neonates.
Preterm neonates (n = 102) born at 34 and 35 weeks of gestation of euthyroid mothers from an iodine-sufficient population were evaluated for T3, T4, free thyroxine (FT4) and TSH during 3-7 days after birth and again after 1 month. The expected date of delivery (EDD) and Ballard score were used to identify the duration of gestation.
The mean gestational age was 34.7 ± 0.41 weeks. The mean (± SD) for T3 (ng/dl), T4 (μg/dl), FT4 (ng/ml) and TSH (μIU/ml) on days 3-7 following birth was as follows: 156 ± 44.6, 12.8 ± 3.7, 1.50 ± 0.54 and 7.13 ± 6.04, respectively. Around 4 weeks of age, values changed to 104 ± 38.4, 12.1 ± 4.02, 1.46 ± 0.42 and 3.25 ± 2.85, respectively. All parameters changed significantly around 4 weeks, except FT4. None of the parameters were correlated with gestational age or body weight at birth. Normative values for each parameter in percentiles were generated.
This study generated the normative values of the thyroid function test during the first week and after around 4 weeks of life for premature neonates (born at 34-35 weeks).
新生儿甲状腺刺激激素（TSH）的初始激增会在出生后24至36小时内使游离三碘甲状腺原氨酸（T3）和总三碘甲状腺原氨酸以及甲状腺素（T4）升高，随后这种影响会逐渐减弱。由于身体和智力发育依赖于正常的甲状腺功能，尤其是在婴儿期，这些儿童的规范数据对于诊断这一亚组婴儿的甲状腺功能减退可能具有巨大价值。关于早产儿甲状腺功能参数的全面规范值几乎没有。本研究的目的是确定早产儿甲状腺功能参数的规范值。
对来自碘充足人群、孕34和35周的甲状腺功能正常母亲所生的早产儿（n = 102）在出生后3至7天以及1个月后评估其T3、T4、游离甲状腺素（FT4）和TSH。使用预产期（EDD）和巴拉德评分来确定孕周。
平均孕周为34.7±0.41周。出生后3至7天，T3（ng/dl）、T4（μg/dl）、FT4（ng/ml）和TSH（μIU/ml）的平均值（±标准差）分别如下：156±44.6、12.8±3.7、1.50±0.54和7.13±6.04。在大约4周龄时，这些值分别变为104±38.4、12.1±4.02、1.46±0.42和3.25±2.85。除FT4外，所有参数在大约4周时均有显著变化。没有一个参数与出生时的孕周或体重相关。生成了每个参数百分位数的规范值。
本研究得出了早产儿（孕34 - 35周出生）出生后第一周及大约4周后甲状腺功能测试的规范值。
