Effects of oral iodine supplementation in very low birth weight preterm infants for the prevention of thyroid function alterations during the neonatal period: results of a randomised assessor-blinded pilot trial and neurodevelopmental outcomes at 24 months

Segura, Susana Ares; Sáenz-Rico, Belén; Arnáez, Juan; Díez‐Sebastián, Jesús; Omeñaca, F; Bernal, Juan

doi:10.1007/s00431-021-04288-5

Cited by 4 publications

(3 citation statements)

References 62 publications

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“…Iodine concentration in milk was higher in the supplemented donors [31]. However, a pilot randomized controlled trial showed no effect of an oral iodine supplementation (30 μg/kg bw/day) on neurodevelopmental morbidity assessed at the corrected age of 2 years in preterms [32 ▪ ]. These negative results are in line with the 2019 Cochrane review [33].…”

Section: Pretermsmentioning

confidence: 51%

Impact of iodine supply in infancy and childhood

Turck

2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of review To assess the most relevant articles on the impact of iodine supply in at-risk populations, namely infants and young children, pregnant and lactating women. Recent findings The 2022 Iodine Global Network Annual Report confirmed the dramatic decrease of severe iodine deficiency over the last 30 years, thanks to universal iodine iodization. However, mild to moderate deficiency is still present in many countries, where recent data showed a decrease of iodine intake and an impairment of iodine status. Unfortunately, there is yet no validated biomarker to classify the iodine status at the individual level. Available data show that there is no clear evidence to link mild-to-moderate iodine deficiency to adverse health outcomes in pregnant and lactating women as well as in infants and children. The description of a negative impact of maternal iodine excess on neurodevelopment of infants is of concern. Summary Optimization of salt iodization (e.g. careful increase in iodine concentration in salt, use by food industry in processed foods) combined with targeted, personalized supplementation under medical supervision if needed (e.g. low intake of iodine rich foods, vegan diet) seems currently preferable to blanket supplementation.

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Section: Pretermsmentioning

confidence: 51%

Impact of iodine supply in infancy and childhood

Turck

2024

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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“…A Cochrane review in 2006 showed inconclusive data regarding iodine supplementation 111 . A recent study by Ares et al 112 evaluated thyroid levels and neurodevelopmental outcomes in VLBW infants after supplementing 30 mcg/day of iodine in 47 preterm infants to provide 30 mcg/kg/day of enteral iodine intake. The results showed an improvement in thyroid levels with no adverse effects.…”

Section: Trace Elements/mineralsmentioning

confidence: 99%

Select micronutrients for the preterm neonate

Barbieri,

Cober

2023

Nut in Clin Prac

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If premature neonates are not provided with adequate nutrition, they will quickly become deficient because of increased requirements and a lack of nutrient stores to achieve adequate growth. The provision of many of the recommended micronutrients for pediatric and adult patients is challenging in premature neonates because of the limited data surrounding the true needs of premature neonates and the difficulty in assessing adequate serum levels of these nutrients in this patient population. Parenteral and enteral nutrition shortages further complicate providing adequate micronutrients to premature neonates. This review will discuss select micronutrients and their importance to the preterm neonate, with special emphasis on micronutrients with limited evidence and more challenging supplementation and repletion strategies.

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“…The study suggest that preterm newborns are at high risk of iodine deficiency, thus their iodine intake should be monitored. Iodine supplementation should be considered if the intake is found to be insufficient (109).…”

Section: Clinical Trials Do Not Correspond With Each Othermentioning

confidence: 99%

Congenital Hypothyroidism in Preterm Newborns – The Challenges of Diagnostics and Treatment: A Review

2022

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Preterm newborns are forced to adapt to harsh extrauterine conditions and endure numerous adversities despite their incomplete growth and maturity. The inadequate thyroid hormones secretion as well as the impaired regulation of hypothalamus-pituitary-thyroid axis may lead to hypothyroxinemia. Two first weeks after birth are pivotal for brain neurons development, synaptogenesis and gliogenesis. The decreased level of thyroxine regardless of cause may lead to delayed mental development. Congenital hypothyroidism (CH) is a disorder highly prevalent in premature neonates and it originates from maternal factors, perinatal and labor complications, genetic abnormalities, thyroid malformations as well as side effects of medications and therapeutic actions. Because of that, the prevention is not fully attainable. CH manifests clinically in a few distinctive forms: primary, permanent or transient, and secondary. Their etiologies and implications bear little resemblance. Therefore, the exact diagnosis and differentiation between the subtypes of CH are crucial in order to plan an effective treatment. Hypothyroxinemia of prematurity indicates dynamic changes in thyroid hormone levels dependent on neonatal postmenstrual age, which directly affects patient’s maintenance and wellbeing. The basis of a successful treatment relies on an early and accurate diagnosis. Neonatal screening is a recommended method of detecting CH in preterm newborns. The preferred approach involves testing serum TSH and fT4 concentrations and assessing their levels according to the cut-off values. The possible benefits also include the evaluation of CH subtype. Nevertheless, the reference range of thyroid hormones varies all around the world and impedes the introduction of universal testing recommendations. Unification of the methodology in neonatal screening would be advantageous for prevention and management of CH. Current guidelines recommend levothyroxine treatment of CH in preterm infants only when the diagnose is confirmed. Moreover, they underline the importance of the re-evaluation among preterm born infants due to the frequency of transient forms of hypothyroidism. However, results from multiple clinical trials are mixed and depend on the newborn’s gestational age at birth. Some benefits of treatment are seen especially in the preterm infants born <29 weeks’ gestation. The discrepancies among trials and guidelines create an urgent need to conduct more large sample size studies that could provide further analyses and consensus. This review summarizes the current state of knowledge on congenital hypothyroidism in preterm infants. We discuss screening and treatment options and demonstrate present challenges and controversies.

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Effects of oral iodine supplementation in very low birth weight preterm infants for the prevention of thyroid function alterations during the neonatal period: results of a randomised assessor-blinded pilot trial and neurodevelopmental outcomes at 24 months

Cited by 4 publications

References 62 publications

Impact of iodine supply in infancy and childhood

Impact of iodine supply in infancy and childhood

Select micronutrients for the preterm neonate

Congenital Hypothyroidism in Preterm Newborns – The Challenges of Diagnostics and Treatment: A Review

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