Topical Iodine and Neonatal Hypothyroidism

Gordon, Catherine M.; Rowitch, David H.; Mitchell, Marvin L.; Kohane, Isaac S.

doi:10.1001/archpedi.1995.02170250042006

Cited by 54 publications

(21 citation statements)

References 18 publications

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“…We have no iodine measurements in this report. A similar but more marked elevation in neonatal TSH has been documented with topical iodine antiseptic use on the neonate in some (9 -13) but not all reports (14,15). It is likely many factors contribute to the variation in outcome between these reports.…”

Section: Discussionmentioning

confidence: 55%

Neonatal Thyrotropin as Measured in a Congenital Hypothyroidism Screening Program: Influence of the Mode of Delivery

McElduff

Wiley

et al. 2005

The Journal of Clinical Endocrinology & Metabolism

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Context: Many developed countries are reexperiencing iodine deficiency. One World Health Organization index of iodine deficiency in populations is the percentage of neonates with TSH levels greater than 5 mIU/liter 72 h after delivery. Measured TSH levels vary with methodology and are influenced by external factors including iodine exposure at time of delivery.Objective: We wished to determine whether babies delivered by cesarean section have higher levels of TSH than babies delivered vaginally because this factor could influence determination of iodine deficiency. Design and Setting: This was a cohort study of mothers delivering at a teaching hospital in 2002-2003 and their babies. Patients and Methods:Women delivering a live infant were eligible for the study. Demographic data, mode of delivery, and subsequent routine newborn screening TSH levels were recorded.Results: Of 2031 infants, 31.2% were delivered by cesarean section; 1864 babies were born after 37 wk, with blood samples collected by d 5 (Ͼ91% on d 3). Significant predictors of TSH concentration were the day TSH was measured and type of delivery. The distribution curve of TSH values was right shifted in infants born by cesarean section. The percentage of neonates born by cesarean with at TSH value greater than 5 was 7.1%. The figure for those born vaginally was 4.3%. Conclusions:Babies delivered by cesarean section are significantly more likely to have TSH levels greater than 5 mIU/liter on d 3 than those delivered vaginally. With the rise in the rate of births by cesarean, this could be an important factor in assessing population iodine deficiency using neonatal TSH levels.

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Section: Discussionmentioning

confidence: 55%

Neonatal Thyrotropin as Measured in a Congenital Hypothyroidism Screening Program: Influence of the Mode of Delivery

McElduff

Wiley

et al. 2005

The Journal of Clinical Endocrinology & Metabolism

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“…8,9 Concern over iodine absorption in neonates is one reason given for exploring the use of CHG as an antiseptic in neonates. In this trial CHG was absorbed from the intact skin of neonates enrolled in the trial.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Transient hypothyroidism has not been widely reported in North America. 8,9 Recent trials in adults and neonates suggest that a cutaneous chlorhexidine gluconate (CHG) scrub before central venous catheter (CVC) or peripheral catheter insertion may be more effective than PI for prevention of CRBSI in adults and catheter colonization in neonates. [10][11][12][13] No current CHG-based antiseptic has been approved by the Federal Drug Administration (FDA) for use in neonates for intravenous catheter placement.…”

Section: Introductionmentioning

confidence: 99%

Pilot trial to compare tolerance of chlorhexidine gluconate to povidone-iodine antisepsis for central venous catheter placement in neonates

et al. 2009

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Objective: The purpose of this pilot trial was to determine whether rates of contact dermatitis following cutaneous antisepsis for central catheter placement were similar among neonates treated with chlorhexidine gluconate and povidone-iodine. Chlorhexidine gluconate absorption was also evaluated.Study Design: Infants weighing X1500 g and X7 days of age were randomized to a 10% povidone-iodine or 2% chlorhexidine gluconate site scrub before catheter placement. Primary outcomes evaluated included dermatitis, catheter colonization and chlorhexidine gluconate absorption.Result: A total of 48 neonates were enrolled. Colonization rates were similar among treatment groups (P<0.6). Dermatitis did not occur at chlorhexidine gluconate (central catheters, n ¼ 24; peripheral catheters, n ¼ 29) sites. Seven neonates had measurable chlorhexidine gluconate concentrations (range 13 to 100 ng ml À1 ) during catheterization. Conclusion:In this small trial chlorhexidine gluconate antisepsis was tolerated by study neonates. Chlorhexidine gluconate was cutaneously absorbed. Larger trials are needed to determine efficacy and tolerance of chlorhexidine gluconate in neonates.

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“…There is some discussion about the possibility that topical treatment with iodine-containing antiseptics could induce transient hyperthyrotropinemia, but the data are controversial [9, 10]. In our screening this factor had no importance since iodine-containing antiseptics are not used in the care of newborns.…”

Section: Resultsmentioning

confidence: 89%

Neonatal Thyroid-Stimulating Hormone Screening as an Indirect Method for the Assessment of Iodine Deficiency in Estonia

Mikelsaar

Viikmaa²

1999

Horm Res Paediatr

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According to neonatal thyroid screening the incidence of congenital hypothyroidism in Estonia is 1:2,860. Transient hyperthyrotropinemia with a raised thyroid-stimulating hormone level of 5 μU/ml occurred in 17.7% of infants and was not associated with low birth weight, small birth length, low gestational age or congenital anomalies. Based on WHO criteria (WHO/UNICEF, 1994) it corresponds to mild iodine deficiency in Estonia (3% or less is in iodine-sufficient areas). This is in agreement with the previously reported median urinary iodine content of 65 μg/l in children. The frequency of infants with TSH >5 μU/ml was 16.4, 21 and 17.2% in three regions (north, central and south) of Estonia, respectively, indicating mild to moderate iodine deficiency. These findings show the possibility of using the results of newborn screening for congenital hypothyroidism to assess the severity of iodine deficiency in Estonia. The introduction of universal iodine prophylaxis is recommended.

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Topical Iodine and Neonatal Hypothyroidism

Cited by 54 publications

References 18 publications

Neonatal Thyrotropin as Measured in a Congenital Hypothyroidism Screening Program: Influence of the Mode of Delivery

Neonatal Thyrotropin as Measured in a Congenital Hypothyroidism Screening Program: Influence of the Mode of Delivery

Pilot trial to compare tolerance of chlorhexidine gluconate to povidone-iodine antisepsis for central venous catheter placement in neonates

Neonatal Thyroid-Stimulating Hormone Screening as an Indirect Method for the Assessment of Iodine Deficiency in Estonia

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