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Nutrients
Volume 13
Issue 4
10.3390/nu13041055
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Article

Postnatal Serum Total Thyroxine of Very Preterm Infants and Long-Term Neurodevelopmental Outcome

by
Yung-Chieh Lin
1,2,†,
Chen-Yueh Wang
3,†,
Yu-Wen Pan
1,
Yen-Ju Chen
1,
Wen-Hao Yu
1,
Yen-Yin Chou
1,2,
Chi-Hsien Huang
4,5,
Wei-Ying Chu
6,
Chyi-Her Lin
1,2,5,7,* and
Osuke Iwata
8,*
1
Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng-Kung University, Tainan 70457, Taiwan
2
Department of Pediatrics, College of Medicine, National Cheng-Kung University, Tainan 70457, Taiwan
3
Department of Pediatrics, Tainan Sinlau Hospital, Tainan 70142, Taiwan
4
Department of Family Medicine, E-Da Hospital, Kaohsiung 82445, Taiwan
5
School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
6
Department of Pediatrics, Tainan Hospital, Ministry of Health and Welfare, Tainan 70043, Taiwan
7
Department of Pediatrics, E-Da Hospital, Kaohsiung 82445, Taiwan
8
Center for Human Development and Family Science, Department of Neonatology and Pediatrics, Nagoya City University Graduate School of Medical Science, Nagoya, Aichi 467-8601, Japan
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Nutrients 2021, 13(4), 1055; https://doi.org/10.3390/nu13041055
Submission received: 30 January 2021 / Revised: 12 March 2021 / Accepted: 20 March 2021 / Published: 24 March 2021
(This article belongs to the Section Nutrition and Public Health)
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Abstract

Primary congenital hypothyroidism is a disease associated with low serum thyroxine and elevated thyroid-stimulating hormone (TSH) levels. The processes of screening and treating congenital hypothyroidism, in order to prevent neurodevelopmental impairment (NDI) in newborns, have been well investigated. Unlike term infants, very preterm infants (VPIs) may experience low thyroxine with normal TSH levels (<10.0 μIU/mL) during long-stay hospitalization. In the current literature, thyroxine treatment has been evaluated only for TSH-elevated VPIs. However, the long-term impact of low thyroxine levels in certain VPIs with normal TSH levels deserves more research. Since July 2007, VPIs of this study unit received screenings at 1 month postnatal age (PNA) for serum TSH levels and total thyroxine (TT4), in addition to two national TSH screenings scheduled at 3–5 days PNA and at term equivalent age. This study aimed to establish the correlation between postnatal 1-month-old TT4 concentration and long-term NDI at 24 months corrected age among VPIs with serial normal TSH levels. VPIs born in August 2007–July 2016 were enrolled. Perinatal demography, hospitalization morbidities, and thyroid function profiles were analyzed, and we excluded those with congenital anomalies, brain injuries, elevated TSH levels, or a history of thyroxine treatments. In total, 334 VPIs were analyzed and 302 (90.4%) VPIs were followed-up. The postnatal TT4 concentration was not associated with NDI after multivariate adjustment (odd ratios 1.131, 95% confidence interval 0.969–1.32). To attribute the NDI of TSH-normal VPIs to a single postnatal TT4 concentration measurement may require more research.
Keywords: very preterm infants; thyroid function; neurodevelopmental outcome; newborn screening; hypothyroxinemia very preterm infants; thyroid function; neurodevelopmental outcome; newborn screening; hypothyroxinemia

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MDPI and ACS Style

Lin, Y.-C.; Wang, C.-Y.; Pan, Y.-W.; Chen, Y.-J.; Yu, W.-H.; Chou, Y.-Y.; Huang, C.-H.; Chu, W.-Y.; Lin, C.-H.; Iwata, O. Postnatal Serum Total Thyroxine of Very Preterm Infants and Long-Term Neurodevelopmental Outcome. Nutrients 2021, 13, 1055. https://doi.org/10.3390/nu13041055

AMA Style

Lin Y-C, Wang C-Y, Pan Y-W, Chen Y-J, Yu W-H, Chou Y-Y, Huang C-H, Chu W-Y, Lin C-H, Iwata O. Postnatal Serum Total Thyroxine of Very Preterm Infants and Long-Term Neurodevelopmental Outcome. Nutrients. 2021; 13(4):1055. https://doi.org/10.3390/nu13041055

Chicago/Turabian Style

Lin, Yung-Chieh, Chen-Yueh Wang, Yu-Wen Pan, Yen-Ju Chen, Wen-Hao Yu, Yen-Yin Chou, Chi-Hsien Huang, Wei-Ying Chu, Chyi-Her Lin, and Osuke Iwata. 2021. "Postnatal Serum Total Thyroxine of Very Preterm Infants and Long-Term Neurodevelopmental Outcome" Nutrients 13, no. 4: 1055. https://doi.org/10.3390/nu13041055

APA Style

Lin, Y.-C., Wang, C.-Y., Pan, Y.-W., Chen, Y.-J., Yu, W.-H., Chou, Y.-Y., Huang, C.-H., Chu, W.-Y., Lin, C.-H., & Iwata, O. (2021). Postnatal Serum Total Thyroxine of Very Preterm Infants and Long-Term Neurodevelopmental Outcome. Nutrients, 13(4), 1055. https://doi.org/10.3390/nu13041055

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