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Thyroid dysfunction in preterm neonates exposed to iodine

Fiona L R Williams, Jennifer Watson, Chris Day

    Journal of Perinatal Medicine
    |August 27, 2016
    PubMed

    Insights

    Topical iodine exposure before cesarean delivery can affect thyroid-stimulating hormone (TSH) levels in preterm infants. Contrast media did not show a similar effect on neonatal thyroid function.

    Area of Science:

    • Neonatal endocrinology
    • Perinatal medicine
    • Thyroid function studies

    Background:

    • Topical iodine avoidance is recommended during pregnancy and breastfeeding for infants under 32 weeks' gestation.
    • Preterm neonates often experience exposure to topical iodine and iodinated contrast media.

    Purpose of the Study:

    • To investigate the impact of intrapartum/neonatal topical iodine and iodinated contrast media exposure on thyrotropin levels in preterm infants.
    • To assess potential neonatal thyroid dysfunction following iodine exposure.

    Main Methods:

    • Recruitment of infants <32 weeks' gestation.
    • Recording maternal and neonatal exposure to iodinated contrast media and topical iodine.
    • Measuring thyrotropin and thyroxine levels from blood-spot cards at specific postnatal days and 36 weeks' gestation.

    Main Results:

    • Higher mean thyrotropin levels were observed in infants exposed to topical iodine before cesarean section compared to unexposed infants.
    • This association persisted after adjustment for confounding factors.
    • Transient hyperthyrotropinemia occurred in three exposed infants; no hypothyroidism was treated.

    Conclusions:

    • Neonatal thyroid dysfunction was observed following iodine exposure via cesarean section.
    • Exposure to iodinated contrast media did not appear to affect neonatal thyroid function in this study.
    Abstract

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