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Published on: November 20, 2015
Treatment of Transient Hypothyroxinemia of Prematurity Does Not Improve Neurodevelopment at Two Years of Age
Angélique Bardet1,2, Marine Vincent3, Aurélie Portefaix4
1Department of Paediatric Endocrinology, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Bron, France.
Insights
Treatment for transient hypothyroxinemia of prematurity (THOP) in very preterm infants did not show improved neurodevelopment compared to untreated THOP. Further research is needed to understand potential treatment effects and biases.
Area of Science:
- Neonatal Medicine
- Endocrinology
- Developmental Pediatrics
Background:
- Transient hypothyroxinemia of prematurity (THOP) is linked to poorer neurodevelopmental outcomes in preterm infants.
- Optimal management strategies for THOP remain under investigation.
Purpose of the Study:
- To evaluate the neurodevelopmental outcomes of very preterm infants with treated versus untreated THOP.
- To compare neurodevelopment at two years of age in infants with and without THOP.
Main Methods:
- A multicentre cohort study included infants born before 32 weeks gestation (2009-2020).
- Infants were categorized into no THOP, treated THOP, and untreated THOP groups.
- Neurodevelopment was assessed at two years via clinical examination.
Main Results:
- No significant difference in neurodevelopment was observed between infants with no THOP and those with THOP (OR 1.4, 95% CI 0.8-2.3).
- Comparing treated versus untreated THOP also showed no significant neurodevelopmental difference (OR 0.8, 95% CI 0.3-1.9).
- These findings persisted after adjusting for confounding factors.
Conclusions:
- In very preterm infants, treated THOP was not associated with improved neurodevelopment compared to untreated THOP.
- Potential biases may have limited the observed treatment effect, warranting further investigation.
Aim:
Transient hypothyroxinemia of prematurity (THOP) has been associated with suboptimal neurodevelopment. We aimed to assess neurodevelopment in very preterm infants with treated and untreated THOP.
Methods:
This study was a multicentre, cohort study, based on prospectively collected data in four French level III neonatal intensive care units. Infants born before 32 weeks of gestation between 2009 and 2020 who underwent a thyroid function test were included. THOP was defined as low free thyroxine and unelevated thyroid stimulating hormone. Infants were classified as no THOP, treated THOP, and untreated THOP. The primary outcome was suboptimal neurodevelopment at 2 years of age evaluated by clinical examination.
Results:
Three hundred and seventy-three infants (54% male) born at a median gestational age of 28 weeks of gestation were included. There was no significant difference in neurodevelopment at 2 years of age when comparing the no THOP to the THOP group (Odds Ratio (OR) 1.4, 95% confident Interval (CI) 0.8-2.3) nor when comparing the treated with the untreated THOP group (OR 0.8, 95% CI 0.3-1.9). Results remained unchanged after adjusting for confounding factors.
Conclusion:
In very preterm infants treated THOP was not associated with improved neurodevelopment compared to untreated THOP. Numerous biases could have limited treatment effect.
