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Response to thyrotropin-releasing hormone stimulation tests in preterm infants with transient hypothyroxinemia of prematurity

Subjects

Abstract

Objective:

Whether hormone supplementation is necessary for infants with transient hypothyroxinemia of prematurity (THOP) remains controversial, and further analysis of the hypothalamus–pituitary–thyroid axis of infants with THOP is necessary.

Study Design:

Thyrotropin-releasing hormone (TRH) stimulation tests were performed at 2 weeks of age in 50 infants with a gestational age of 30 weeks or less, and the data were analyzed retrospectively.

Result:

Subjects were divided into three groups; group A consisted of euthyroid infants, group B consisted of infants with THOP and group C consisted of hypothyroid infants. The basal and peak thyroid-stimulating hormone level of group C in response to TRH stimulation tests was significantly higher than the others, but no differences were observed between groups A and B.

Conclusion:

The response of infants with THOP to the TRH stimulation test was not different from that of euthyroid infants, which suggested that their hypothalamic–pituitary–thyroid axis was appropriately regulated in infants with THOP.

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References

  1. Reuss ML, Leviton A, Paneth N, Susser M . Thyroxine values from newborn screening of 919 infants born before 29 weeks’ gestation. Am J Public Health 1997; 87 (10): 1693–1697.

    Article  CAS  Google Scholar 

  2. Sureka Bollepalli SRR . Disorders of the thyroid gland. In: Christine A, Gleason SUD (eds) Avery’s Disease of the Newborn. 9th edn, Elsevier: Philadelphia, PA, USA, 2012, pp 1307–1319.

    Book  Google Scholar 

  3. Rapaport R, Rose SR, Freemark M . Hypothyroxinemia in the preterm infant: the benefits and risks of thyroxine treatment. J Pediatr 2001; 139 (2): 182–188.

    Article  CAS  Google Scholar 

  4. van Wassenaer AG, Kok JH, de Vijlder JJ, Briet JM, Smit BJ, Tamminga P et al. Effects of thyroxine supplementation on neurologic development in infants born at less than 30 weeks’ gestation. N Engl J Med 1997; 336 (1): 21–26.

    Article  CAS  Google Scholar 

  5. Osborn DA, Hunt RW . Postnatal thyroid hormones for preterm infants with transient hypothyroxinaemia. Cochrane Database Syst Rev 2007; (1): CD005945.

  6. Briet JM, van Wassenaer AG, Dekker FW, de Vijlder JJ, van Baar A, Kok JH . Neonatal thyroxine supplementation in very preterm children: developmental outcome evaluated at early school age. Pediatrics 2001; 107 (4): 712–718.

    Article  CAS  Google Scholar 

  7. La Gamma EF, van Wassenaer AG, Ares S, Golombek SG, Kok JH, Quero J et al. Phase 1 trial of 4 thyroid hormone regimens for transient hypothyroxinemia in neonates of <28 weeks’ gestation. Pediatrics 2009; 124 (2): e258–e268.

    Article  Google Scholar 

  8. van Wassenaer-Leemhuis A, Ares S, Golombek S, Kok J, Paneth N, Kase J et al. Thyroid hormone supplementation in preterm infants born before 28 weeks gestational age and neurodevelopmental outcome at age 36 months. Thyroid 2014; 24 (7): 1162–1169.

    Article  CAS  Google Scholar 

  9. Niwa F, Kawai M, Kanazawa H, Iwanaga K, Matsukura T, Hasegawa T et al. Hyperthyrotropinemia at 2 weeks of age indicates thyroid dysfunction and predicts the occurrence of delayed elevation of thyrotropin in very low birth weight infants. Clin Endocrinol (Oxf) 2012; 77 (2): 255–261.

    Article  CAS  Google Scholar 

  10. Okada J, Iwata S, Hirose A, Kanda H, Yoshino M, Maeno Y et al. Levothyroxine replacement therapy and refractory hypotension out of transitional period in preterm infants. Clin Endocrinol (Oxf) 2011; 74 (3): 354–364.

    Article  CAS  Google Scholar 

  11. Kawai M, Kusuda S, Cho K, Horikawa R, Takizawa F, Ono M et al. Nationwide surveillance of circulatory collapse associated with levothyroxine administration in very-low-birthweight infants in Japan. Pediatr Int 2012; 54 (2): 177–181.

    Article  CAS  Google Scholar 

  12. Takizawa F, Kashimada K, Enomoto K, Miyai K, Ono M, Asada G et al. Two preterm infants with late onset circulatory collapse induced by levothyroxine sodium. Pediatr Int 2010; 52 (3): e154–e157.

    Article  Google Scholar 

  13. Yagasaki H, Kobayashi K, Nemoto A, Naito A, Sugita K, Ohyama K . Late-onset circulatory dysfunction after thyroid hormone treatment in an extremely low birth weight infant. J Pediatr Endocrinol Metab 2010; 23 (1–2): 153–158.

    CAS  PubMed  Google Scholar 

  14. Rapaport R, Sills I, Patel U, Oppenheimer E, Skuza K, Horlick M et al. Thyrotropin-releasing hormone stimulation tests in infants. J Clin Endocrinol Metab 1993; 77 (4): 889–894.

    CAS  PubMed  Google Scholar 

  15. de Zegher F, Pernasetti F, Vanhole C, Devlieger H, Van den Berghe G, Martial JA . The prenatal role of thyroid hormone evidenced by fetomaternal Pit-1 deficiency. J Clin Endocrinol Metab 1995; 80 (11): 3127–3130.

    CAS  PubMed  Google Scholar 

  16. Vulsma T, Gons MH, de Vijlder JJ . Maternal-fetal transfer of thyroxine in congenital hypothyroidism due to a total organification defect or thyroid agenesis. N Engl J Med 1989; 321 (1): 13–16.

    Article  CAS  Google Scholar 

  17. Haddow JE, Palomaki GE, Allan WC, Williams JR, Knight GJ, Gagnon J et al. Maternal thyroid deficiency during pregnancy and subsequent neuropsychological development of the child. N Engl J Med 1999; 341 (8): 549–555.

    Article  CAS  Google Scholar 

  18. van Wassenaer AG, Kok JH, Dekker FW, de Vijlder JJ . Thyroid function in very preterm infants: influences of gestational age and disease. Pediatr Res 1997; 42 (5): 604–609.

    Article  CAS  Google Scholar 

  19. Den Ouden AL, Kok JH, Verkerk PH, Brand R, Verloove-Vanhorick SP . The relation between neonatal thyroxine levels and neurodevelopmental outcome at age 5 and 9 years in a national cohort of very preterm and/or very low birth weight infants. Pediatr Res 1996; 39 (1): 142–145.

    Article  CAS  Google Scholar 

  20. Ares S, Quero J, Diez J, Morreale de Escobar G . Neurodevelopment of preterm infants born at 28 to 36 weeks of gestational age: the role of hypothyroxinemia and long-term outcome at 4 years. J Pediatr Endocrinol Metab 2011; 24 (11-12): 897–902.

    Article  CAS  Google Scholar 

  21. Leviton A, Paneth N, Reuss ML, Susser M, Allred EN, Dammann O et al. Hypothyroxinemia of prematurity and the risk of cerebral white matter damage. J Pediatr 1999; 134 (6): 706–711.

    Article  CAS  Google Scholar 

  22. Lucas A, Morley R, Fewtrell MS . Low triiodothyronine concentration in preterm infants and subsequent intelligence quotient (IQ) at 8 year follow up. BMJ 1996; 312 (7039): 1132–1133; discussion 1133-1134.

    Article  CAS  Google Scholar 

  23. Meijer WJ, Verloove-Vanhorick SP, Brand R, van den Brande JL . Transient hypothyroxinaemia associated with developmental delay in very preterm infants. Arch Dis Child 1992; 67 (7): 944–947.

    Article  CAS  Google Scholar 

  24. Hadeed AJ, Asay LD, Klein AH, Fisher DA . Significance of transient postnatal hypothyroxinemia in premature infants with and without respiratory distress syndrome. Pediatrics 1981; 68 (4): 494–498.

    CAS  PubMed  Google Scholar 

  25. Cuestas RA, Engel RR . Thyroid function in preterm infants with respiratory distress syndrome. J Pediatr 1979; 94 (4): 643–646.

    Article  CAS  Google Scholar 

  26. Polk DH, Reviczky A, Lam RW, Fisher DA . Thyrotropin-releasing hormone in ovine fetus: ontogeny and effect of thyroid hormone. Am J Physiol 1991; 260 (1 Pt 1): E53–E58.

    CAS  PubMed  Google Scholar 

  27. Koivusalo F . Evidence of thyrotropin-releasing hormone activity in autopsy pancreata from newborns. J Clin Endocrinol Metab 1981; 53 (4): 734–736.

    Article  CAS  Google Scholar 

  28. Kaptein EM, Beale E, Chan LS . Thyroid hormone therapy for obesity and nonthyroidal illnesses: a systematic review. J Clin Endocrinol Metab 2009; 94 (10): 3663–3675.

    Article  CAS  Google Scholar 

  29. Biondi B, Cooper DS . The clinical significance of subclinical thyroid dysfunction. Endocr Rev 2008; 29 (1): 76–131.

    Article  CAS  Google Scholar 

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Correspondence to A Yamamoto.

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Yamamoto, A., Kawai, M., Iwanaga, K. et al. Response to thyrotropin-releasing hormone stimulation tests in preterm infants with transient hypothyroxinemia of prematurity. J Perinatol 35, 725–728 (2015). https://doi.org/10.1038/jp.2015.67

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