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[Physiopathological implications of thyroid function in premature infants]
Insights
Recent advancements in thyroid hormone testing and congenital hypothyroidism screening have improved understanding of fetal and newborn thyroid function. This paper reviews key thyroid dysfunctions in premature infants, crucial for accurate diagnosis.
Area of Science:
- Endocrinology
- Neonatology
- Pediatric Medicine
Context:
- Significant advancements in thyroid hormone assays and mass screening for congenital hypothyroidism over the past 20 years.
- Expanded understanding of the development of the fetal and neonatal hypothalamus-hypophysis-thyroid axis.
- Focus on premature infants, a vulnerable population with unique thyroid function considerations.
Purpose:
- To present the latest advancements in the assessment of thyroid function in fetuses and newborns.
- To discuss specific thyroid dysfunction syndromes observed in premature infants.
- To highlight the importance of considering these syndromes during congenital hypothyroidism screening in newborns.
Summary:
- Reviews recent improvements in thyroid hormone measurement techniques and congenital hypothyroidism screening.
- Details the development of the fetal and neonatal hypothalamus-pituitary-thyroid axis.
- Discusses transient hypothyroxinemia, transient primary hypothyroidism, transient idiopathic hyperthyrotropinemia, and low T3 syndrome in premature infants.
Impact:
- Enhances diagnostic accuracy for thyroid dysfunction in premature infants.
- Informs clinical practice regarding the screening of newborns for congenital hypothyroidism.
- Contributes to a better understanding of neonatal thyroidology and its clinical implications.
Abstract:
The last two decades have been characterized by a remarkable improvement of the methods used for the determination of thyroid hormones concentration as well as by mass screening of congenital hypothyroidism. This has resulted in an expanded knowledge on the development of the hypothalamus-hypophysis-thyroid function in the fetus and in newborn. The paper presents the latest advancements in this field. The following thyroid dysfunction syndromes in premature infants are discussed: transient hypothyroxinemia, transient primary hypothyroidism, transient idiopathic hyperthyrotropinemia, low T3 - syndrome. All these conditions should be taken into consideration while determining the thyroid function in premature infants, particularly while screening newborns with congenital hypothyroidism.