General Movement assessment and neurodevelopmental trajectory in extremely preterm infants with hypothyroxinaemia of

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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

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Dimple Goel1, Melissa Luig2, Rajesh Maheshwari1

  • 1Westmead Hospital, Sydney, Australia; University of Sydney, Sydney, Australia.

Early Human Development
|November 1, 2019
PubMed

Insights

Infants with transient hypothyroxinaemia of prematurity (THOP) showed better neurodevelopmental outcomes than those with normal thyroid levels. This study highlights potential risks associated with normal fT4 levels in preterm infants.

Area of Science:

  • Neonatal endocrinology
  • Neurodevelopmental pediatrics
  • Perinatal medicine

Background:

  • Transient hypothyroxinaemia of prematurity (THOP) is linked to neurodevelopmental deficits, yet clinical practices vary due to limited research.
  • Understanding the impact of thyroid hormone levels on preterm infant development is crucial for optimizing care.

Purpose of the Study:

  • To investigate the association between free thyroxine (fT4) levels at two weeks of age and early neurodevelopmental outcomes in extremely preterm infants.
  • To explore the relationship between fT4 levels and general movements assessment (GMA) and Bayley Scales of Infant Development (BSID-III) scores.

Main Methods:

  • A retrospective analysis of prospectively collected data from infants born before 29 weeks gestation.
  • Evaluated fT4 levels at 2 weeks, GMA at 36 weeks and 3 months, and BSID-III at 2 years corrected age.
  • Compared outcomes between infants with and without THOP (fT4 >1SD below the mean).

Main Results:

  • Infants with normal fT4 levels (No-THOP group) exhibited poorer neurodevelopmental outcomes compared to the THOP group.
  • Significantly lower cognitive and motor scores were observed in the No-THOP group at 2 years corrected age (p=0.01 and p=0.04, respectively).
  • While not statistically significant, there was a trend towards more abnormal General Movements in the No-THOP group.

Conclusions:

  • This study is the first to describe General Movements in preterm infants with THOP.
  • Infants without THOP demonstrated significantly worse cognitive and motor outcomes at 2 years corrected age, suggesting potential risks associated with normal fT4 levels in this population.
Abstract

Keywords:
General Movement AssessmentHypothyroxinaemia of prematurity (THOP)NeonateNeurodevelopmental outcomesPreterm

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