Neonatal Thyroid Function in Iodine Deficiency

Delange, François; Bourdoux, Pierre; Laurence, Michael; Peneva, L; Walfish, Paul G.; Willgerodt, H

doi:10.1007/978-1-4899-1245-9_23

Cited by 22 publications

(15 citation statements)

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“…Again, transient hypothyroidism during early life can result in loss of intellectual capacities in children in Europe and could account for the shift of IQ values towards low values reported in schoolchildren in endemic goiter areas in Europe [87], A transiently elevated serum TSH level with a normal T4 concentration (transient hyperthyrotropinemia) is also frequently reported in newborn populations of mod erately iodine-deficient countries [104], For example, and as indicated earlier, this picture accounts for 3 of 4 of the infants recalled under suspicion of congenital hypothyroidism in Belgium, where iodine intake is bor derline (50-90 pg iodine/day in adults). More generally speaking, figure 2 indicates that there is an inverse rela tionship between the urinary iodine concentration in newborn populations in Europe used as an index of their state of iodine nutrition and the frequency of serum TSH levels >50 pU/ml on day 5 at the time of screening of congenital hypothyroidism, i.e., in the recall rate under suspicion of congenital hypothyroidism.…”

Section: ]mentioning

confidence: 99%

“…The particular sensitivity of the newborn to the effects of iodine deficiency is due to its very low iodine content of the thyroid with a markedly accelerated turnover rate of intrathyroidal iodine [87,104].…”

Section: ]mentioning

confidence: 99%

“…If transient but occurring during the critical period of brain development, it is responsible for the state of endemic mental retardation reported in clinically euthyroid indi viduals in areas of endemic goiter. If more persistent, it can result in the full picture of myxedematous endemic cretinism [88], A mild degree of iodine deficiency as seen in Europe [103] is frequently accompanied by transient hypothy roidism and transient hyperthyrotropinemia in the neo nate [104], The prevalence of transient hypothyroidism in the neonate is almost eight times higher in Europe than in North America where the iodine intake is much higher than in Europe. The syndrome is characterized by postnatally acquired severe primary hypothyroidism lasting for a few weeks and requiring substitutive therapy [105].…”

Section: ]mentioning

confidence: 99%

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Neonatal Screening for Congenital Hypothyroidism Results and Perspectives

Delange¹

1997

Horm Res

201

110

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Systematic screening for congenital hypothyroidism in the neonate constitutes a major progress in the prevention of mental retardation, as the condition occurs in 1/4,000 newborns and necessarily results in brain damage if not properly detected and treated during the first days of life. Screening and diagnostic and therapeutic procedures are discussed, as well as outcome and prognosis of the affected infants. Primary thyroid-stimulating hormone screening is almost universally recommended. Early therapy (within 14 days) with appropriate doses of thyroxine (about 10 µg/kg/day) will prevent any brain damage even in case of evidence of fetal hypothyroidism, as thyroxine of maternal origin will reach the fetus and largely protect him. Neonatal thyroid screening is also a particularly sensitive monitoring tool in the evaluation of the effects and of the correction of iodine deficiency at the population level.

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Section: ]mentioning

confidence: 99%

Section: ]mentioning

confidence: 99%

Section: ]mentioning

confidence: 99%

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Neonatal Screening for Congenital Hypothyroidism Results and Perspectives

Delange¹

1997

Horm Res

201

110

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“…The hypersensitivity of neonates to the effects of iodine deficiency is explained by their very small intrathyroidal iodine pool, which requires increased TSH stimulation and a fast turnover rate in order to maintain normal secretion of thyroid hormones (Delange, 1998). In severe iodine deficiency, as in the mothers, the biochemical picture of neonatal hypothyroidism is caricatural, especially in the DRC where mean cord serum thyroxine and TSH concentrations are 95.2 nmol/l and 70.7 mU/l respectively and where as many as 11% of the neonates have both a cord serum TSH above 100 mU/l and a cord thyroxine below 38.6 nmol/l, that is a biochemical picture similar to the one found in thyroid agenesis (Delange et al, 1993).…”

Section: Perinatal Thyroid Function and Iodine Deficiencymentioning

confidence: 78%

Hypothyroidism

Osama¹,

Ahme²

2012

A New Look at Hypothyroidism

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“…The hypersensitivity of the neonates to the effects of I deficiency is explained by their very small intrathyroidal I pool, which requires increased TSH stimulation and a fast turnover rate in order to maintain normal secretion of thyroid hormones (Delange et al 1993).…”

Section: Thyroid Function In the Neonatesmentioning

confidence: 99%

The role of iodine in brain development

Delange¹

2000

Proc. Nutr. Soc.

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163

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I is required for the synthesis of thyroid hormones. These hormones, in turn, are required for brain development, which occurs during fetal and early postnatal life. The present paper reviews the impact of I deficiency (1) on thyroid function during pregnancy and in the neonate, and (2) on the intellectual development of infants and children. All extents of I deficiency (based on I intake (μg/d); mild 50–99, moderate 20–49, severe > 20) affect the thyroid function of the mother and neonate, and the mental development of the child. The damage increases with the extent of the deficiency, with overt endemic cretinism as the severest consequence. This syndrome combines irreversible mental retardation, neurological damage and thyroid failure. Maternal hypothyroxinaemia during early pregnancy is a key factor in the development of the neurological damage in the cretin. Se deficiency superimposed on I deficiency partly prevents the neurological damage, but precipitates severe hypothyroidism in cretins. I deficiency results in a global loss of 10–15 intellectual quotient points at a population level, and constitutes the world’s greatest single cause of preventable brain damage and mental retardation.

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Neonatal Thyroid Function in Iodine Deficiency

Cited by 22 publications

References 5 publications

Neonatal Screening for Congenital Hypothyroidism Results and Perspectives

Neonatal Screening for Congenital Hypothyroidism Results and Perspectives

Hypothyroidism

The role of iodine in brain development

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