Detection of Congenital Hypothyroidism in Premature Infants

Research Article| September 01 2024 Detection of Congenital Hypothyroidism in Premature Infants AAP Grand Rounds (2024) 52 (3): 34. https://doi.org/10.1542/gr.52-3-34 Views Icon Views Article contents Figures 52 (3): 34. https://doi.org/10.1542/gr.52-3-34 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: congenital hypothyroidism, infant, premature, thyrotropin, hypothyroidism Source: Shah AN , Li W , Zheng D , et al . A practical gestational age-based algorithm for timely detection of hypothyroidism in premature infants (published online ahead of print May, 11, 2024). J Perinatol. 2024; doi: https://doi.org/10.1038/s41372-024-01985-5.Google Scholar Investigators from the University of Texas Health Sciences Center at Houston, Houston, TX, and the University of Wisconsin, Madison, WI, conducted a retrospective study to evaluate the use of an algorithm for repeated screening for congenital hypothyroidism in premature infants. The algorithm was developed for use in newborns born at 10 uIU/mL) and fT4 level. To evaluate the outcomes of the screening algorithm, medical record data on infants born at <35 weeks' gestation between June 2018 and April 2021 and treated at a single NICU where the algorithm was used were reviewed. In addition to state newborn screening results and fT4 and TSH levels, data abstracted on study participants included gestational age at birth, birth weight, and treatment with LT4. For those receiving LT4, length of treatment with LT4 was collected from the medical record to assess whether the patient had transient or permanent hypothyroidism. Differences between infants treated for hypothyroidism and those without hypothyroidism were assessed with Wilcoxon rank sum tests. In addition, rates of treatment in the 10 years prior to implementation of the algorithm and following implementation were compared. Data were analyzed on 938 preterm infants. Of these, 29% were born at <28 weeks' gestation, and 39% were born at 28 to <32 weeks' gestation. A total of 16 infants were treated with LT4, yielding an incidence of treated hypothyroidism of 1.7%. Three of the 16 patients were identified by the state newborn screen. Mean gestational ages were similar among those treated for hypothyroidism and infants without hypothyroidism (30.6 and 30.4 weeks' gestation, respectively; P = 0.8), but those in the treatment group had significantly lower birth weights (mean, 815g and 1,350g, respectively; P = 0.02). Four infants treated for hypothyroidism died prior to NICU discharge. Of the remaining 12, 2 were lost to follow-up, 2 were classified with transient hypothyroidism, and 8 with permanent hypothyroidism. Overall, the rate of treatment for hypothyroidism was significantly higher following implementation of the algorithm compared to the previous 10 years (1.7% vs 1.0%; P = 0.03). This increase was because of more treatment of premature infants with birth weights ≥2,500g. There was no significant difference in rate of treatment for those with birth weights <2,500g. The authors conclude that repeated fT4 and TSH testing led to... You do not currently have access to this content.