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Topical iodine and neonatal hypothyroidism
C M Gordon1, D H Rowitch, M L Mitchell
1Division of Endocrinology, Children's Hospital, Harvard Medical School, Boston, Mass, USA.
Archives of Pediatrics & Adolescent Medicine
|December 1, 1995
Summary
Routine use of povidone-iodine skin care in neonatal intensive care units did not lead to primary hypothyroidism in infants. Despite elevated urine iodine levels, thyroid function remained largely unaffected in neonates during the first 10 days of life.
Area of Science:
- Neonatal Medicine
- Endocrinology
- Pediatric Dermatology
Background:
- Cutaneous exposure to povidone-iodine (PI) antiseptic solutions is common in neonatal intensive care units (NICUs).
- There is a concern that PI use may lead to primary hypothyroidism in neonates due to iodine absorption.
Purpose of the Study:
- To investigate the risk of primary hypothyroidism in NICU patients exposed to iodine-containing disinfectants.
- To assess the impact of cutaneous povidone-iodine applications on neonatal thyroid function.
Main Methods:
- A prospective pilot study was conducted in a Level III NICU.
- 47 NICU patients undergoing procedures requiring povidone-iodine application were enrolled.
- Thyroid function tests and urine iodine concentrations were measured 7-10 days post-exposure.
Main Results:
- No cases of primary hypothyroidism were documented in the 47 subjects.
- Mean urine iodine concentrations were significantly elevated compared to reference values.
- Thyroid function tests (thyroxine and thyrotropin levels) were within normal ranges for most subjects.
Conclusions:
- Routine NICU povidone-iodine skin care appears to not substantially alter thyroid function in neonates within the first 10 days of life.
- Long-term or high-dose iodine exposure in other clinical settings may still pose a risk.
- Potential masking effects of medications like dopamine and dexamethasone on thyrotropin levels cannot be ruled out.