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Congenital hypothyroidism with a delayed thyroid-stimulating hormone elevation in very premature infants: incidence

Hyung Chul Woo1, Ariel Lizarda, Richard Tucker

  • 1Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, RI, USA.

The Journal of Pediatrics
|January 15, 2011
PubMed

Insights

Extremely low birth weight (ELBW) and very low birth weight (VLBW) infants have a higher incidence of congenital hypothyroidism (CH) with delayed thyroid-stimulating hormone (TSH) elevation. However, their developmental outcomes are comparable to control infants.

Area of Science:

  • Neonatal screening and endocrinology.
  • Pediatric development and outcomes.

Background:

  • Congenital hypothyroidism (CH) is a common endocrine disorder in newborns.
  • Delayed thyroid-stimulating hormone (TSH) elevation can occur in infants with CH.
  • The impact of CH with delayed TSH elevation on extremely low birth weight (ELBW) and very low birth weight (VLBW) infants requires further investigation.

Purpose of the Study:

  • To determine if ELBW and VLBW infants have an increased incidence of CH with delayed TSH elevation.
  • To compare the developmental, growth, and endocrine outcomes of these infants with control groups.

Main Methods:

  • Retrospective analysis of newborn thyroid screening data from 92,800 live births in Rhode Island.
  • Identification of CH cases with delayed TSH elevation.
  • Assessment of developmental, growth, and endocrine outcomes at 18 months corrected age.

Main Results:

  • CH with delayed TSH elevation occurred significantly more often in ELBW (1 in 58) and VLBW (1 in 95) infants compared to those weighing ≥1500 grams (1 in 30,329).
  • VLBW infants with CH and delayed TSH elevation showed a higher incidence of head circumference below the 10th percentile.
  • Despite this, mean head circumferences, weights, lengths, and developmental scores were similar between CH infants and matched controls.
  • Three infants required short-term levothyroxine treatment.

Conclusions:

  • ELBW and VLBW infants exhibit a higher incidence of CH with delayed TSH elevation.
  • The long-term outcomes for these infants are comparable to their non-CH peers, suggesting effective management and monitoring.
Abstract

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