Related Experiment Video

Updated: Jun 16, 2026

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
06:15

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus

Published on: March 6, 2019

Thyroid function in term and late preterm infants with respiratory distress in relation to severity of illness

David A Paul1, Amy Mackley, Erika M Yencha

  • 1Section of Neonatology, Department of Pediatrics, Christiana Care Health System, Newark, Delaware 19803, USA. dpaul@christianacare.org

Thyroid : Official Journal of the American Thyroid Association
|February 16, 2010
PubMed

Insights

In ill term and late preterm infants, lower free thyroxine (fT(4)) levels correlate with increased illness severity. Infants needing inhaled nitric oxide also showed reduced fT(4).

Area of Science:

  • Neonatal Medicine
  • Endocrinology
  • Critical Care

Background:

  • Transient hypothyroxinemia is common in premature infants.
  • Limited data exists for ill term and late preterm infants.
  • Hypothesized inverse relationship between free thyroxine (fT(4)) and illness severity in these infants.

Purpose of the Study:

  • Investigate the association between illness severity and thyroid hormone levels in term and late preterm infants with respiratory distress.
  • Determine if fT(4) levels correlate with markers of respiratory illness severity.

Main Methods:

  • Study included infants >=35 weeks gestation requiring respiratory support.
  • Collected thyroid function tests (TSH, T4, fT4, FT3) and cortisol levels at specified intervals.
  • Assessed illness severity using the Score for Neonatal Acute Physiology (SNAP).

Main Results:

  • Infants with SNAP >=10 had diminished TSH at birth.
  • Found an inverse correlation between SNAP at birth and fT(4).
  • Lowest fT(4) inversely correlated with mean airway pressure, oxygenation index, and A-a gradient.
  • Infants receiving inhaled nitric oxide had lower fT(4) levels.

Conclusions:

  • Severity of illness in term and late preterm infants is associated with fT(4) levels at birth.
  • Infants requiring inhaled nitric oxide exhibited decreased fT(4) over the study period.
  • Further research is needed to evaluate potential benefits of T(4) supplementation.
Abstract

Related Concept Videos

Functions of Thyroid Hormones01:18

Functions of Thyroid Hormones

The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
Hypothyroidism II: Pathophysiology01:23

Hypothyroidism II: Pathophysiology

Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...
Synthesis and Regulation of Thyroid Hormones01:20

Synthesis and Regulation of Thyroid Hormones

Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...
Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
Goiter01:27

Goiter

Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...
Assessment of Airway, Skin Color, and Use of Accessory Muscles01:30

Assessment of Airway, Skin Color, and Use of Accessory Muscles

A thorough assessment of respiratory health is paramount in clinical settings to identify and manage respiratory distress and ensure adequate oxygenation. This article elaborates on the critical aspects of respiratory evaluation, including airway assessment, skin color examination, and the observation of accessory muscle use, which are integral to effectively diagnosing and managing patients with respiratory conditions.
Introduction
The initial evaluation of a patient's respiratory system...