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[A clinical analysis of hypothyroidism in very low birth weight/extremely low birth weight infants]
Hui Zhang1, Yun-Pu Cui, Tong-Yan Han
1Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China. jessypupu@sina.com.
Insights
Hypothyroidism affects 17.9% of very low birth weight/extremely low birth weight infants. Risk factors include being small for gestational age, multiple births, advanced maternal age, and dopamine use.
Area of Science:
- Neonatal endocrinology
- Pediatric thyroid disorders
Background:
- Hypothyroidism is a significant concern in premature infants.
- Very low birth weight (VLBW) and extremely low birth weight (ELBW) infants are particularly vulnerable.
Purpose of the Study:
- To investigate the incidence, risk factors, and treatment outcomes of hypothyroidism in VLBW/ELBW infants.
- To identify key clinical predictors and associations.
Main Methods:
- A case-control study comparing 29 VLBW/ELBW infants with hypothyroidism to 87 matched controls.
- Analysis of clinical features, gestational age, birth weight, and risk factors.
Main Results:
- Hypothyroidism incidence was 17.9% in VLBW/ELBW infants, increasing with lower birth weight.
- Independent risk factors identified: small for gestational age, multiple birth, advanced maternal age (≥35 years), and dopamine use.
- Levothyroxine treatment (5-10 μg/kg daily) normalized thyroid function in 2 weeks for treated infants.
Conclusions:
- VLBW/ELBW infants have a high rate of hypothyroidism.
- Early identification and management of risk factors are crucial.
- Regular follow-up is essential for infants treated with levothyroxine to ensure appropriate dosing.
Objective:
To study the risk factors and treatment outcome of hypothyroidism in very low birth weight/extremely low birth weight (VLBW/ELBW) infants.
Methods:
The VLBW/ELBW infants who were diagnosed with hypothyroidism from September 2018 to December 2019 were enrolled as the case group (n=29). The children with normal thyroid function, matched at a ratio of 1 : 3, were enrolled as the control group (n=87). Clinical features were compared between the two groups. The correlation of thyroid function with gestational age and birth weight and the risk factors for hypothyroidism were analyzed.
Results:
A total of 162 VLBW/ELBW infants who met the inclusion criteria were enrolled, with 29 infants in the case group (an incidence rate of hypothyroidism of 17.9%). The lower the birth weight, the higher the incidence rate of hypothyroidism (P<0.05). Triiodothyronine (T3) and free T3 were positively correlated with gestational age (P<0.05). T3 and free thyroxine were positively correlated with birth weight (P<0.05). Small for gestational age, multiple birth, maternal age ≥ 35 years, and use of dopamine were independent risk factors for hypothyroidism (P<0.05). In the case group, 16 infants were treated with levothyroxine (5-10 μg/kg daily), and the thyroid function returned to normal after 2 weeks of treatment.
Conclusions:
There is a high incidence rate of hypothyroidism in VLBW/ELBW infants. Small for gestational age, multiple birth, advanced maternal age, and use of dopamine are risk factors for hypothyroidism. The infants treated with levothyroxine should be followed up regularly to ensure an appropriate dose.
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