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Trials with thyroid hormone in preterm infants: clinical and neurodevelopmental effects

Aleid G van Wassenaer1, Joke H Kok

  • 1Department of Neonatology, Emma Childrens' Hospital Academic Medical Center, Amsterdam, The Netherlands. a.vanwassenaer@amc.uva.nl

Seminars in Perinatology
|November 15, 2008
PubMed

Insights

Thyroid hormone treatment in premature infants shows mixed neurodevelopmental results based on gestational age. While beneficial for those born earliest, it may harm later-preterm infants, necessitating further research.

Area of Science:

  • Neonatology
  • Endocrinology
  • Developmental Neuroscience

Background:

  • Limited trials exist on thyroid hormone use in premature infants, with most focusing on short-term outcomes.
  • Few studies have investigated long-term neurodevelopmental effects or impacts on mortality and morbidities.

Purpose of the Study:

  • To review existing trials on thyroid hormone administration in premature infants.
  • To analyze the impact of thyroid hormone treatment on neurodevelopmental outcomes, considering gestational age.

Main Methods:

  • Systematic review of clinical trials involving thyroid hormone therapy in premature infants.
  • Analysis of neurodevelopmental endpoints up to 10 years of age, with subgroup analysis based on gestational age.

Main Results:

  • A trend towards reduced patent ductus arteriosus was observed in treated infants.
  • Thyroxine administration showed gestational age-dependent effects on neurodevelopmental outcomes.
  • Infants <28 weeks gestation demonstrated improved mental, motor, and neurological outcomes, while those of 29 weeks gestation showed worse outcomes.

Conclusions:

  • Future trials should prioritize long-term neurodevelopmental outcomes in premature infants receiving thyroid hormone therapy.
  • Continuous thyroid hormone administration may be more effective than bolus dosing.
  • Gestational age is a critical factor in determining the neurodevelopmental impact of thyroid hormone treatment.

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