Hypothyroidism in the Newborn

Sobel, Edna H.; Saenger, Paul

doi:10.1542/pir.11-1-15

Cited by 9 publications

(5 citation statements)

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“…This is consistent with previous descriptive studies of congenital hypothyroidism and is thought to represent transient hypothyroxinemia, due to incomplete thyroid gland development [20,21]. We also found hypothyroidism during infancy to be associated with increased maternal age, with the greatest risk for those aged 40 years and older.…”

Section: Discussionsupporting

confidence: 92%

Hypothyroidism among military infants born in countries of varied iodine nutrition status

Cranston

Ryan²,

Smith

et al. 2010

BMC Endocr Disord

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BackgroundIodine deficiency is a global problem representing the most common preventable cause of mental retardation. Recently, the impact of subtle deficiencies in iodine intake on children and pregnant women has been questioned. This study was designed to compare hypothyroidism among infants born to US military families in countries of varied iodine nutrition status.MethodsA cohort design was used to analyze data from the Department of Defense Birth and Infant Health Registry for infants born in 2000-04 (n = 447,691). Hypothyroidism was defined using ICD-9-CM codes from the first year of life (n = 698). The impact of birth location on hypothyroidism was assessed by comparing rates in Germany, Japan, and US territories with the United States, while controlling for infant gender, plurality, gestational age, maternal age, maternal military status, and military parent's race/ethnicity.ResultsHypothyroidism did not vary by birth location with adjusted odds ratios (OR) as follows: Germany (OR 0.82, [95% CI 0.50, 1.35]), Japan (OR 0.67, [95% CI 0.37, 1.22]), and US territories (OR 1.29, [95% CI 0.57, 2.89]). Hypothyroidism was strongly associated with preterm birth (OR 5.44, [95% CI 4.60, 6.42]). Hypothyroidism was also increased among infants with civilian mothers (OR 1.24, [95% CI 1.00, 1.54]), and older mothers, especially ages 40 years and older (OR 2.09, [95% CI 1.33, 3.30]).ConclusionsIn this study, hypothyroidism in military-dependent infants did not vary by birth location, but was associated with other risk factors, including preterm birth, civilian maternal status, and advanced maternal age.

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Section: Discussionsupporting

confidence: 92%

Hypothyroidism among military infants born in countries of varied iodine nutrition status

Cranston

Ryan²,

Smith

et al. 2010

BMC Endocr Disord

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“…Our study confirmed the already known higher prevalence of CH among females than males. 9 – 12 In fact, in this case-control study, a 2-fold higher risk of permanent CH was estimated in females than in males. However, it is still unclear why females were more susceptible to developing CH.…”

Section: Discussionmentioning

confidence: 63%

Risk factors for congenital hypothyroidism in Egypt: results of a population case-control study (2003–2010)

Abdelmoktader

2013

Annals of Saudi Medicine

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BACKGROUND AND OBJECTIVESAlthough the prevention of the neuropsychological consequences of congenital hypothyroidism (CH) through the use of replacement therapy represents an important public health success, knowledge about the modifiable risk factors could reduce the number of infants affected by this disease. This study was carried out to identify risk factors for CH at Fayoum Governorate, Egypt.DESIGN AND SETTINGSThis was a population-based case-control study, which started in 2003 and was carried out for 8 years through Fayoum center of the Egyptian Ministry of Health and Population screening program for CH.METHODSThis study was a population-based case-control study carried out by using national project for CH. One control was enrolled for each new CH infant; 320 cases and 320 controls were enrolled in 8 years. Maternal and neonatal influences were investigated.RESULTSA statistically significant association of CH was observed with birth defects, female gender, gestational age >40 weeks, and gestational diabetes. An increased risk for CH was detected in twins by a multivariate analysis.CONCLUSIONOur results suggest a multifactorial origin of CH in which genetic (high frequency of additional malformations) and environmental factors (especially maternal diabetes) play a role in the development of the disease.

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“…The normal IQ of early diagnosed and appropriately treated children emphasizes the importance of such a treatment during the critical first year of life [4][5][6][7][8], However, it has been shown that many children suffer ing from CH have high serum thyroid-stimulating hor mone (TSH) concentration for prolonged periods of time despite adequate replacement therapy, clinical euthyroidism and normal levels of thyroid hormones [9][10][11][12][13], It appears that the hypothalamic pituitary threshold for TSH suppression by thyroid hormones is raised, but the mechanism is not yet evident [9,12,13]. It is not clear either whether this high TSH is biologically active or not.…”

Section: Introductionmentioning

confidence: 99%

The Importance of Thyroglobulin Levels in Monitoring the Treatment of Congenital Hypothyroidism

Sack¹,

Kaiserman²,

Eidlitz‐Markus³

1995

Horm Res

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We have previously reported on high thyroid-stimulating hormone (TSH) concentrations in clinically euthyroid children with congenital (CH) undergoing appropriate treatment. Whether this TSH is biologically active or not is still unclear. It has been shown that ectopic thyroid tissue does not involute during thyroxine (T₄) therapy and thus can continue to secrete thyroglobulin (Tg). This study was undertaken to determine whether the Tg levels in ectopic CH infants represent residual thyroid tissue stimulated by biologically active TSH and whether this Tg can be used to help monitor CH treatment. Among the 51 primary CH children (age 2-14 years) diagnosed and followed up by us, 28 had measurable Tg values ( > 2 pmol/l) several years after the T₄ treatment had been started. In 8 of the children, Tg was measured as early as the time of diagnosis and followed up for at least 3 years. The Tg levels decreased much more slowly than the TSH levels did, and secondary Tg rises were observed. By 5 months of age, all children had Tg levels less than 25 pmol/l. Although in some infants the Tg levels paralleled TSH behavior, in others the TSH-Tg correlation was not so obvious. In another group of 8 children who had high TSH values despite normal T₄, the LT₄ replacement dosage was increased by 60% for 1 week (from 3.5 ± 0.2 to 5.5 ± 0.5 μg/kg/day) in order to examine the TSH-Tg dependence. As a result, the serum levels of T₄ increased from 143 ± 10 to 176 ± 12 nmol/l, while the levels of TSH and Tg decreased from 8.1 ± 2.1 mU/l and 4.5 ± 0.5 ρmol/l to 1.7 ± 0.5 mU/l and 2.9 ± 0.6 pmol/l, respectively (p < 0.05). The data suggest that in primary CH children with ectopic thyroid tissue the residual gland is active and secretes Tg in response to endogenous TSH, years after the T₄ replacement treatment has been started. Therefore the high TSH found in some CH children despite adequate LT₄ replacement treatment is biologically active and easily suppressible with the increase in LT₄ dosage. Since Tg is TSH dependent and since Tg clearance is much slower compared to TSH clearance, Tg might be useful in monitoring more accurately the long-term compliance to the therapeutic protocol. Tg monitoring is especially valuable in those infants with fluctuating high TSH levels despite normal T₄ values.

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Hypothyroidism in the Newborn

Cited by 9 publications

References 10 publications

Hypothyroidism among military infants born in countries of varied iodine nutrition status

Hypothyroidism among military infants born in countries of varied iodine nutrition status

Risk factors for congenital hypothyroidism in Egypt: results of a population case-control study (2003–2010)

The Importance of Thyroglobulin Levels in Monitoring the Treatment of Congenital Hypothyroidism

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