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Thyroid function in preterm infants and neurodevelopment at 2 years

Fiona L R Williams1, Alice Lindgren2, Jennifer Watson3

  • 1Division of Population Health & Genomics, School of Medicine, University of Dundee, Dundee, UK f.l.r.williams@dundee.ac.uk.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|February 22, 2020
PubMed

Insights

Mild thyroid dysfunction in preterm infants is linked to lower neurodevelopmental scores at two years. Many affected infants are missed by current screening, highlighting a need for improved detection methods.

Area of Science:

  • Neonatal Medicine
  • Endocrinology
  • Developmental Pediatrics

Background:

  • Postnatal thyroid dysfunction is common in preterm infants.
  • The impact of mild thyroid dysfunction on neurodevelopment is not well understood.

Purpose of the Study:

  • To investigate the relationship between thyroid function and neurodevelopment in preterm infants.
  • To identify if mild thyroid dysfunction affects cognitive and motor outcomes.

Main Methods:

  • A cohort analysis of 1275 infants born before 31 weeks' gestation.
  • Thyroid function tests (TSH, TBG, T4) were measured in dried blood spots.
  • Neurodevelopment was assessed at 2 years using the Bayley-III Scales.

Main Results:

  • Infants in the top decile for thyroid-stimulating hormone showed reduced cognitive and motor scores.
  • Infants in the bottom decile for thyroxine levels had significantly lower motor scores.
  • No infants were identified as hypothyroid by routine screening.

Conclusions:

  • Consistent mild thyroid dysfunction in preterm infants is associated with poorer neurodevelopmental outcomes.
  • Current screening protocols may not detect many infants with mild thyroid dysfunction.
  • Further research is needed to optimize screening and management for thyroid dysfunction in preterm infants.
Abstract

Keywords:
endocrinologyneonatology

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