Related Experiment Videos
Thyroid function in very preterm newborns: possible implications
A G Van Wassenaer1, J H Kok, J M Briët
1Emma Children's Hospital AMC, Department of Neonatology and Experimental Pediatric Endocrinology, Amsterdam, The Netherlands.
Thyroid : Official Journal of the American Thyroid Association
|February 26, 1999
Summary
Thyroid hormone (T4) supplementation in very preterm infants showed a trend toward improved outcomes. Further trials are needed to confirm benefits, especially for infants under 27 weeks gestation.
Area of Science:
- Neonatalogy
- Endocrinology
- Neuroscience
Background:
- Thyroid hormones are crucial for infant brain development.
- Very preterm infants often exhibit low thyroxine (T4) and free thyroxine (FT4) levels.
- Transient hypothyroxinemia may contribute to neurodevelopmental disabilities in preterm infants.
Purpose of the Study:
- To investigate the effects of T4 supplementation on neurodevelopmental outcomes in very preterm infants.
- To assess the impact of T4 on hormone levels, mortality, and morbidity in this population.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 200 infants under 30 weeks gestation.
- T4 (or placebo) was administered at 8 microg/kg/day for the first 6 weeks of life.
- Hormone levels (T4, FT4, rT3, TSH, T3), mortality, morbidity, heart rate, and neurodevelopmental outcomes at 2 years were assessed.
Main Results:
- T4 supplementation significantly increased T4, FT4, and rT3 levels, while suppressing TSH and decreasing T3.
- Mortality rates were 14% in the T4 group versus 21% in the placebo group (not significant).
- A trend toward improved adverse outcomes (death or abnormal development) was observed; mental outcomes were significantly better in T4-treated infants <27 weeks gestation.
Conclusions:
- Current trial results are not conclusive regarding T4 supplementation benefits in very preterm infants.
- Further research is warranted to determine if T4 supplementation is necessary for infants <27-28 weeks gestation.
- Consideration should be given to including T3 in future treatment protocols.