Thyroxine for transient hypothyroxinemia and cerebral palsy in extremely preterm infants

Suzumura, Hiroshi; Nitta, Akihisa; Tsuboi, Y; Watabe, Yoshiyuki; Kuribayashi, Ryouta; Arisaka, Osamu

doi:10.1111/j.1442-200x.2010.03287.x

Cited by 16 publications

(11 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There were no short‐term beneficial effects of thyroxine treatment and sufficient neurodevelopmental data were lacking . One study of 60 ELGANs showed that levothyroxine treatment for free thyroxine levels of less than 0.8 ng/dL at the end of the first week of life could reduce the incidence of cerebral palsy, when compared to a former cohort of 54 ELGANs who did not receive treatment . However, we must be careful with these results, because a historical control group was used and cerebral palsy rates have generally decreased over time.…”

Section: Resultsmentioning

confidence: 99%

Review shows that thyroid hormone substitution could benefit transient hypothyroxinaemia of prematurity but treatment strategies need to be clarified

et al. 2019

View full text Add to dashboard Cite

Aim Thyroid hormones are crucial for foetal and neonatal brain development. This paper provides an overview of the normal role of thyroid hormones in foetal brain development and the pathophysiology of transient hypothyroxinaemia of prematurity (THOP). It also discusses the diagnostic and therapeutic controversies around THOP and looks at directions for future research. Methods We used the PubMed and Embase databases to identify papers published in English from 1969 to June 2018. This identified 20 papers about the impact of THOP on neurodevelopment and seven randomised controlled trials about therapeutic approaches from 1981–2016. Results THOP has been researched for more than three decades. The impact of temporarily low thyroxine levels, without any increase in pituitary‐secreted thyroid‐stimulating hormone at a critical timeframe in an infant's brain development, is still debated. Heterogeneity in THOP definitions, difficulties with thyroid hormone assessment, identifying patients at risk and a clear lack of sufficiently powered studies add to the current controversy. There are indications that thyroid hormone substitution might be useful in extremely low gestational age neonates with THOP. Conclusion Some preterm infants could benefit from THOP treatment, but more studies are needed to clarify further treatment strategies, including the optimal timing of initiation and duration.

show abstract

Section: Resultsmentioning

confidence: 99%

Review shows that thyroid hormone substitution could benefit transient hypothyroxinaemia of prematurity but treatment strategies need to be clarified

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Multiple clinical trials have been conducted, however a systematic review failed to find any significant difference in neonatal mortality, morbidity or neurodevelopmental outcomes in preterm infants who received thyroid hormones compared to controls (Osborn and Hunt, 2007). Since then, additional studies have been completed (Suzumura et al, 2011; Ng et al, 2014; Van Wassenaer-Leemhuis et al, 2014), however only Suzumura et al, found any neurodevelopmental benefit of thyroxine supplementation in preterm infants.…”

Section: Emergent Interventionsmentioning

confidence: 99%

Emergent Prophylactic, Reparative and Restorative Brain Interventions for Infants Born Preterm With Cerebral Palsy

et al. 2019

View full text Add to dashboard Cite

Worldwide, an estimated 15 million babies are born preterm (<37 weeks' gestation) every year. Despite significant improvements in survival rates, preterm infants often face a lifetime of neurodevelopmental disability including cognitive, behavioral, and motor impairments. Indeed, prematurity remains the largest risk factor for the development of cerebral palsy. The developing brain of the preterm infant is particularly fragile; preterm babies exhibit varying severities of cerebral palsy arising from reductions in both cerebral white and gray matter volumes, as well as altered brain microstructure and connectivity. Current intensive care therapies aim to optimize cardiovascular and respiratory function to protect the brain from injury by preserving oxygenation and blood flow. If a brain injury does occur, definitive diagnosis of cerebral palsy in the first few hours and weeks of life is difficult, especially when the lesions are subtle and not apparent on cranial ultrasound. However, early diagnosis of mildly affected infants is critical, because these are the patients most likely to respond to emergent treatments inducing neuroplasticity via high-intensity motor training programs and regenerative therapies involving stem cells. A current controversy is whether to test universal treatment in all infants at risk of brain injury, accepting that some patients never required treatment, because the perceived potential benefits outweigh the risk of harm. Versus, waiting for a diagnosis before commencing targeted treatment for infants with a brain injury, and potentially missing the therapeutic window. In this review, we discuss the emerging prophylactic, reparative, and restorative brain interventions for infants born preterm, who are at high risk of developing cerebral palsy. We examine the current evidence, considering the timing of the intervention with relation to the proposed mechanism/s of action. Finally, we consider the development of novel markers of preterm brain injury, which will undoubtedly lead to improved diagnostic and prognostic capability, and more accurate instruments to assess the efficacy of emerging interventions for this most vulnerable group of infants.

show abstract

“…Ancak düşük T4 düzeyleri ile gelişme geriliği ve serebral palsi arasında bir ilişki de gösterilmiştir [30]. Bir araştırmada 27 haftadan küçük olan prematürele-re LT4 verilmesi Bayley zihinsel gelişim skorunun kontrol grubuna göre daha yüksek bulunmasına yol açmıştır [31].…”

Section: İzlem Ve Tedavisiunclassified

Insidious danger in childhood era's: subclinical hypothyroidism

2017

View full text Add to dashboard Cite

Insidious danger in childhood era's; subclinical hypothyroidism erleme d Öz Tiroid hormonları; santral sinir sistemi gelişimi, büyüme, gelişme, vücut ısısı regülasyonu, lipit, karbonhidrat ve enerji metabolizması, iskelet sistemi üzerinde önemli role sahiptir. Diğer yönden çocukluk çağında santral sinir sistemi myelinizasyonunda görevli olduğu için önemi farklıdır. Subklinik hipotiroidi, serum tiroid stimulan hormon seviyesinin orta düzeyde artması ile birlikte serum tiroid hormon seviyelerinin normal referans laboratuvar aralı-ğında olmasıdır. Çocuklarda %2 oranında görülmektedir. Etiyolojisinin büyük bir kısmını otoimmün tiroidit ve iyot eksikliği oluşturmaktadır. Asemptomatik olguların zamanında tanımlanması ve tedavisi önemlidir. Olgularda guatr, büyüme-gelişme geriliği veya duraksaması, ders başarısında azalma, negativizm, depresyon, obezite, demir eksikliği anemisi, dislipidemi, kemik yaşı geriliğinde levotiroksin tedavisi başlanması uygundur. Anahtar sözcükler: Çocukluk çağı, subklinik hipotiroidizm AbstractThyroid hormones have an important role on the central nervous system, growth, development, body temperature regulation, metabolism of lipid, carbohydrate and energy, musculoskeletal system. The other hand, it has a different importance for its role in the myelinization of the central nervous system during the childhood period. Subclinical hypothyroidism (SH), is diagnosed when peripheral thyroid hormone levels are within normal reference laboratory range but serum thyroid-stimulating hormone levels are mildly elevated. Prevalance of subclinical hypothyroidism in chilhood is seen about %2. The majority of its etiology is due to the autoimmune thyroiditis and iodine deficiency. It is important to diagnose and treat the asymptomatic cases in a timely manner. Thyroxin treatment should be started if goiter, growth velocity is slowed down, decline in school success, negativism, depression, obesity, refractory iron deficiency anemia dyslipidemia, bone age retardation.

show abstract

Thyroxine for transient hypothyroxinemia and cerebral palsy in extremely preterm infants

Cited by 16 publications

References 36 publications

Review shows that thyroid hormone substitution could benefit transient hypothyroxinaemia of prematurity but treatment strategies need to be clarified

Review shows that thyroid hormone substitution could benefit transient hypothyroxinaemia of prematurity but treatment strategies need to be clarified

Emergent Prophylactic, Reparative and Restorative Brain Interventions for Infants Born Preterm With Cerebral Palsy

Insidious danger in childhood era's: subclinical hypothyroidism

Contact Info

Product

Resources

About