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Thyroid-stimulating hormone reference ranges for moderate-to-late preterm infants.

Dinushan C Kaluarachchi¹, Victoria M Nicksic², David B Allen²

¹Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, USA. kaluarachchi@pediatrics.wisc.edu.

Journal of Perinatology : Official Journal of the California Perinatal Association

|December 6, 2020

Summary

Newborn screening for congenital hypothyroidism in moderate-to-late preterm infants requires specific thyroid-stimulating hormone (TSH) reference ranges. This study establishes TSH reference charts for these infants, crucial for accurate diagnosis.

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Area of Science:

Neonatal Medicine
Endocrinology
Pediatric Screening

Background:

Congenital hypothyroidism identification via newborn screening (NBS) is more prevalent in moderate-to-late preterm (MLPT) infants.
Current NBS protocols utilize identical thyroid-stimulating hormone (TSH) cutoffs for both term and preterm infants.
Established TSH reference ranges specifically for MLPT infants are currently unavailable.

Purpose of the Study:

To establish TSH reference ranges for MLPT infants.
To develop TSH reference charts for MLPT infants aged 32-36 weeks gestation.

Main Methods:

Analysis of 10,987 TSH levels from NBS samples.
Inclusion of 8499 MLPT infants born between 32 and 36 weeks gestation.
Definition of TSH percentiles (median, 5th, 25th, 75th, 95th, 99th) from day 1 to day 14 of life.

Main Results:

TSH levels demonstrated a gradual decrease post-birth, stabilizing around day 6.
TSH reference charts were constructed for MLPT infants from day 1 to day 14.
The study utilized a state-wide cohort for comprehensive data analysis.

Conclusions:

TSH reference charts were successfully developed for MLPT infants (day 1-14).
Future research should investigate the correlation between age-adjusted TSH percentiles and long-term neurodevelopmental outcomes.
Optimal TSH cutoffs for MLPT infants require further determination based on neurodevelopmental data.