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Postnatal thyroid hormones for preterm infants with transient hypothyroxinaemia

D A Osborn1, R W Hunt

  • 1Royal Prince Alfred Hospital, RPA Newborn Care, Missenden Road, Camperdown, New South Wales, Australia, 2050. david.osborn@email.cs.nsw.gov.au

The Cochrane Database of Systematic Reviews
|January 27, 2007
PubMed

Insights

Thyroid hormone therapy for preterm infants with transient hypothyroxinaemia shows insufficient evidence for improving neonatal outcomes or neurodevelopment. Further research is needed to determine its effectiveness and safety in this vulnerable population.

Area of Science:

  • Neonatal Medicine
  • Endocrinology
  • Developmental Pediatrics

Background:

  • Extremely premature infants often experience transient hypothyroxinaemia (low thyroid hormone levels) in early life.
  • This condition is linked to increased neonatal morbidity, mortality, and long-term developmental issues.
  • Thyroid hormone therapy is being explored as a potential intervention to mitigate these risks.

Purpose of the Study:

  • To evaluate the efficacy of thyroid hormone therapy in preterm infants diagnosed with transient hypothyroxinaemia.
  • To assess the impact of this therapy on neonatal outcomes and neurodevelopmental trajectories.
  • To determine if thyroid hormone supplementation can prevent adverse effects associated with low thyroid hormone levels in preterm neonates.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases, including CENTRAL, MEDLINE, EMBASE, and conference proceedings.
  • Eligible trials included preterm infants with transient hypothyroxinaemia (low thyroid hormone, normal TSH) randomly assigned to thyroid hormone therapy or a control group (placebo/no treatment).
  • Data were extracted and analyzed using standard Cochrane Collaboration methods, calculating relative risks and weighted mean differences.

Main Results:

  • Only one eligible study, involving 23 infants, was identified.
  • The study found no significant differences in neonatal mortality, bronchopulmonary dysplasia, or other major morbidities between thyroxine and placebo groups.
  • No significant differences in growth parameters or thyroid hormone levels were observed, and neurodevelopmental follow-up was inadequate.

Conclusions:

  • There is insufficient evidence to support the use of thyroid hormones for treating transient hypothyroxinaemia in preterm infants.
  • The current evidence does not demonstrate improvements in neonatal morbidity and mortality or reductions in neurodevelopmental impairments.
  • Further rigorous research is necessary to establish the role and safety of thyroid hormone therapy in this population.
Abstract

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