The Relation of Transient Hypothyroxinemia in Preterm Infants to Neurologic Development at Two Years of Age

Reuss, Mary Lynne; Paneth, Nigel; Pinto‐Martin, Jennifer; Lorenz, John M.; Susser, Mervyn

doi:10.1097/00006254-199608000-00010

Cited by 69 publications

(102 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Conversely, present clinical and experimental evidence seems to suggest that early and prolonged (until week 24) maternal hypothyroxinemia is a risk factor for impaired foetal brain development (3,22,(24)(25)(26). Moreover, other reports of poor developmental outcome in preterm babies indicate that a normal supply of maternal T 4 continues to have an important protective role after midgestation (27,28). Because of the potential irreversibility of foetal brain damage, we decided arbitrarily to give substitutive L-T 4 treatment to women experiencing IH, in order to ensure FT 4 levels similar to those observed in adequately iodine supplemented women at the same stage of pregnancy.…”

Section: Discussionmentioning

confidence: 96%

Gestational thyroid function abnormalities in conditions of mild iodine deficiency: early screening versus continuous monitoring of maternal thyroid status

Moleti

Presti

Mattina

et al. 2009

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: To longitudinally evaluate the timing of maternal thyroid underfunction occurrence in mildly iodine-deficient (ID) pregnant women, and ultimately assess the benefit of thyroid function testing at early gestation only in identifying maternal thyroid underfunction. Participants/methods: Serum free-thyroxine and TSH were measured in 220 consecutive women once in early pregnancy (by week 12) and twice per trimester subsequently. Anti-thyroperoxidase and antithyroglobulin were also determined at initial and final observation. Results: Thyroid autoantibodies were detectable in 8.2% women. Overall, the prevalence of hypothyroidism over the course of gestation was 11.8% (26/220), with a relative risk of hypothyroidism in antibody-positive women of 5.0 (c 2 20.02, P!0.0005). Nonetheless, almost 70% hypothyroid women tested negative for thyroid autoantibodies. Fifteen/26 (57.7%) hypothyroid women were identified at presentation, and the remaining 11 at either early (6/11) or late (5/11) phases of the 2nd trimester. Isolated hypothyroxinemia was observed in 56/220 (25.4%) women, mostly from the 2nd trimester onwards. Conclusions: In mildly ID areas thyroid function testing early in gestation seems to be only partly effective in identifying thyroid underfunction in pregnant women. Indeed, in our series more than 40% hypothyroid women would not have been diagnosed had we limited our observation to early thyroid function tests alone. Although thyroid autoimmunity carried a 5-fold increased risk of hypothyroidism, iodine deficiency seems to be a major determinant in the occurrence of thyroid underfunction. Adequate iodine supplementation should be strongly recommended to meet the increased hormone demand over gestation.

show abstract

Section: Discussionmentioning

confidence: 96%

Gestational thyroid function abnormalities in conditions of mild iodine deficiency: early screening versus continuous monitoring of maternal thyroid status

Moleti

Presti

Mattina

et al. 2009

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…(Previous papers 7,20 mistakenly cited five steps rather than ten steps as the walking criterion; no case of CP was classified as disabled based on this criterion).…”

Section: Outcomes Of Interestmentioning

confidence: 99%

Magnesium Sulfate in Labor and Risk of Neonatal Brain Lesions and Cerebral Palsy in Low Birth Weight Infants

Jetton²,

et al. 1997

Self Cite

View full text Add to dashboard Cite

ABSTRACT. Objectives. We tested the hypothesis that administration of magnesium sulfate in labor protects against the development of neonatal brain lesions and cerebral palsy (CP) in low birth weight infants.Methods. Magnesium exposure was ascertained in a population-based cohort of 1105 infants weighing 2000 g or less through review of medical records of maternal magnesium sulfate administration and, where available, elevated maternal serum magnesium levels. Neonatal germinal matrix/intraventricular hemorrhage and parenchymal brain lesions were ascertained by a prospective, timed ultrasound scanning protocol in the first week of life. CP was ascertained at 2 years of age by clinical examination in 80% of survivors and by interview and medical record review in another 6% and was classified as disabling or nondisabling. Conclusions. The hypothesis that magnesium sulfate use reduces the risk of neonatal brain lesions or CP in low birth weight infants was not statistically supported in this study, although a modest reduction in risk of DCP cannot be excluded. The data further suggest that magnesium exposure may be associated with reduction in risk of CP in low birth weight infants who have lateonset brain lesions, but this unpredicted observation requires confirmation in another data set. Pediatrics 1997; 99(5). URL: http://www.pediatrics.org/cgi/content/full/99/ 5/e1; cerebral palsy; magnesium sulfate; infant, low birth weight; preeclampsia; cerebral hemorrhage, infant. Results. No significant reduction in risk of nondisabling CP (adjusted odds ratio [OR

show abstract

“…Motor and cognitive deficits are seen in these children despite early thyroxine replacement. Thus, even transiently low thyroxine levels are considered to be a potent risk factor for adverse neurodevelopmental outcome in preterm infants and have been the subject of many elegant long-term studies [1][2][3][4][5]. All cohorts have documented a measure of abnormal mental development in children with THOP.…”

Section: E D I T O R I a L E D I T O R I A L E D I T O R I A L E D I mentioning

confidence: 99%

“…Firstly, the very cut-off value of T 4 used by the authors to define THOP is much higher that the usually accepted definitions. Though there is no consensus on the level of thyroxine for defining hypothyroxinemia in the preterm, definitions used by other authors have been 2 [1], 2.6 [2], or 3 [3,4] SDS below the mean thyroxine level seen on newborn screening of the reference population. Other authors have used an absolute cut-off level like 40 nmol/L [7] or 6 mcg/ dL for T 4 [8].…”

Section: E D I T O R I a L E D I T O R I A L E D I T O R I A L E D I mentioning

confidence: 99%

Transient hypothyroxinemia of prematurity: Does it have clinical relevance?

Seth

2012

Indian Pediatr

View full text Add to dashboard Cite

The Relation of Transient Hypothyroxinemia in Preterm Infants to Neurologic Development at Two Years of Age

Cited by 69 publications

References 0 publications

Gestational thyroid function abnormalities in conditions of mild iodine deficiency: early screening versus continuous monitoring of maternal thyroid status

Gestational thyroid function abnormalities in conditions of mild iodine deficiency: early screening versus continuous monitoring of maternal thyroid status

Magnesium Sulfate in Labor and Risk of Neonatal Brain Lesions and Cerebral Palsy in Low Birth Weight Infants

Transient hypothyroxinemia of prematurity: Does it have clinical relevance?

Contact Info

Product

Resources

About