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Thyroid Function in the Neonatal Intensive Care Unit.

Monika Chaudhari1, Jonathan L Slaughter2

  • 1Department of Pediatrics, Division of Endocrinology, Nationwide Children's Hospital, The Ohio State University, 700 Children's Crossroad, Columbus, OH 43205, USA.

Clinics in Perinatology
|February 7, 2018
PubMed
Summary
This summary is machine-generated.

Neonatal intensive care unit (NICU) infants face high risks for abnormal thyroid function due to illness and preterm birth. This review covers thyroid function testing, interpretation, and levothyroxine treatment for NICU patients.

Keywords:
Congenital hypothyroidismNeonatal intensive care unitPreterm infantsThyroid function testingThyroid screeningThyroid testing artifacts

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Area of Science:

  • Neonatal endocrinology
  • Pediatric thyroid disorders

Background:

  • Neonatal intensive care unit (NICU) patients, particularly preterm infants, exhibit immature hypothalamic-pituitary-thyroid axis regulation.
  • Illness and prematurity contribute to a high incidence of abnormal thyroid function testing in this vulnerable population.
  • Thyroid function can be abnormal even with initially normal screening tests.

Purpose of the Study:

  • To review normal hypothalamic-pituitary-thyroid axis maturation in neonates.
  • To discuss thyroid hormone testing and interpretation in the NICU setting.
  • To evaluate the evidence for and against levothyroxine treatment in NICU patients with borderline abnormal thyroid function.

Main Methods:

  • Literature review of studies on thyroid function in preterm and sick neonates.
  • Analysis of normal hypothalamic-pituitary-thyroid axis development.
  • Examination of current evidence regarding levothyroxine intervention for borderline thyroid dysfunction.

Main Results:

  • Preterm infants have immature feedback mechanisms for thyroid hormone regulation.
  • Thyroid function abnormalities can manifest later in NICU infants despite normal initial screening.
  • Evidence for levothyroxine treatment in NICU patients with borderline results is currently debated.

Conclusions:

  • Understanding thyroid axis maturation is crucial for interpreting thyroid tests in NICU infants.
  • Careful consideration of diagnostic criteria and treatment evidence is necessary for managing thyroid dysfunction in this population.
  • Further research is needed to establish optimal management strategies for borderline thyroid function in NICU patients.