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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.
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Thyroid-Stimulating Hormone Reference Ranges for Preterm Infants.

Dinushan C Kaluarachchi1, David B Allen2, Jens C Eickhoff3

  • 1Departments of Pediatrics and kaluarachchi@pediatrics.wisc.edu.

Pediatrics
|July 18, 2019
PubMed
Summary
This summary is machine-generated.

Thyroid-stimulating hormone (TSH) reference ranges vary significantly in preterm infants. Establishing age-adjusted TSH cutoffs for newborn screening is crucial to avoid misdiagnosing congenital hypothyroidism in premature babies.

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Area of Science:

  • Neonatal Medicine
  • Endocrinology
  • Public Health

Background:

  • Newborn screening (NBS) programs utilize repeat testing for congenital hypothyroidism.
  • Significant variability exists in thyroid-stimulating hormone (TSH) cutoff values across NBS programs.
  • Limited data are available on TSH reference ranges in preterm infants based on postnatal age.

Purpose of the Study:

  • Determine TSH reference ranges for preterm infants born before 32 weeks' gestation.
  • Establish age-adjusted TSH percentiles from birth to term equivalent gestational age for preterm infants.

Main Methods:

  • Analysis of serial TSH levels from NBS in infants born between 22 and 31 weeks' gestation (2012-2016).
  • Cohort divided into two groups: 22-27 weeks and 28-31 weeks' gestation.
  • TSH percentiles calculated from birth to term equivalent gestational age for each group.

Main Results:

  • The 95th percentile TSH level showed a decreasing trend, reaching a nadir at different weeks for each group (10-11 weeks for 22-27 weeks, 5-6 weeks for 28-31 weeks).
  • At 3-4 weeks postnatal, 95th percentile TSH ranged from 11 to 11.8 μIU/mL (22-27 weeks) and 8.2 to 9 μIU/mL (28-31 weeks).
  • Total cohort included 1022 infants (22-27 weeks) and 2115 infants (28-31 weeks).

Conclusions:

  • Constructed TSH reference charts for preterm infants (<32 weeks' gestation) from birth to term equivalent age.
  • A single TSH cutoff for all preterm infants may lead to misdiagnosis of congenital hypothyroidism.
  • Gestational-age-specific TSH differences may explain higher congenital hypothyroidism diagnoses in preterm infants, supporting age-adjusted NBS TSH cutoffs.