Iodine overload and severe hypothyroidism in a premature neonate

Use of iodinated skin disinfectants in the perinatal period can result in significant iodine overload of the neonate and transient hypothyroidism. The authors report a case of unusually severe hypothyroidism requiring L-thyroxine (L-T4) replacement therapy in a premature neonate after prolonged use of iodinated skin disinfectants for a complex skin lesion. Neonatal iodine overload should be minimized, and in cases with significant iodine exposure, thyroid-stimulating hormone should be monitored, especially in preterm neonates who are exquisitely sensitive to the antithyroid effects of iodine excess.