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Factors associated with moderate neonatal hyperthyrotropinemia.

Ernesto Cortés-Castell1, Mercedes Juste1, Antonio Palazón-Bru2

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High neonatal thyroid-stimulating hormone (TSH) is linked to male sex and maternal ethnicity, not gestational age. Understanding these factors helps target iodine supplementation for better infant thyroid health.

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Area of Science:

  • Neonatal endocrinology
  • Public health nutrition
  • Maternal-fetal medicine

Background:

  • Maternal iodine deficiency is associated with elevated neonatal thyroid-stimulating hormone (TSH) levels.
  • A TSH threshold of 5 mIU/L is a key indicator for assessing iodine nutrition status in newborns.
  • Identifying factors influencing neonatal TSH is crucial for accurate iodine status assessment and targeted interventions.

Purpose of the Study:

  • To investigate risk factors that may affect the validity of neonatal TSH as a marker for iodine nutrition.
  • To identify specific demographic and clinical factors associated with elevated neonatal TSH.
  • To inform strategies for iodine supplementation in at-risk pregnant women and newborns.

Main Methods:

  • A case-control study involving 46,622 newborns in Spain (2002-2015).
  • Analysis focused on neonatal TSH values ≥5 mIU/L as the primary outcome.
  • Logistic regression was used to identify associated factors, including sex, gestational age, sampling day, and maternal origin.

Main Results:

  • Male sex was associated with a higher risk of elevated TSH (OR = 1.34).
  • Maternal origin showed varied associations, with lower odds for newborns from America and Africa compared to Spain.
  • Fewer days between birth and sample extraction correlated with higher TSH levels (OR = 0.80).

Conclusions:

  • Elevated neonatal TSH, independent of congenital hypothyroidism, is more prevalent in males.
  • The risk of high TSH decreases with delayed sample collection after birth.
  • Gestational age was not found to be a significant factor, but maternal ethnicity influences neonatal TSH levels.