Thyroid function and dysfunction in preterm infants—Challenges in evaluation, diagnosis and therapy
| Autor: | Nikolina Zdraveska, Mirjana Kocova |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
endocrine system
medicine.medical_specialty Pediatrics endocrine system diseases Endocrinology Diabetes and Metabolism Gestational Age 030209 endocrinology & metabolism Thyroid Function Tests Thyroid function tests Thyroid dysgenesis 03 medical and health sciences 0302 clinical medicine Endocrinology Hypothyroidism Internal medicine medicine Humans medicine.diagnostic_test business.industry Thyroid Infant Newborn Infant Gestational age medicine.disease Low birth weight medicine.anatomical_structure 030220 oncology & carcinogenesis Gestation Thyroid function medicine.symptom business Infant Premature Hormone |
| Zdroj: | Clinical Endocrinology. 95:556-570 |
| ISSN: | 1365-2265 0300-0664 |
| Popis: | Thyroid hormone levels have a crucial role for optimal brain development from gestation through the first 2 postnatal years. However, thyroid hormones vary with gestational age, and their levels vary between term and preterm infants. Preterm newborns are prone to thyroid dysfunction which is now more frequently observed with the advances of neonatal care and improved survival of extremely premature infants. Thus, hypothyroxinaemia of prematurity associated with delayed TSH elevation is very common in low birth weight premature infants most likely due to the immaturity of the hypothalamic-pituitary thyroid axis. Furthermore, postnatal illness, medications and iodine status may contribute to the thyroid dysfunction or affect the interpretation of the thyroid function tests. Despite available guidelines, timing of screening and optimal treatment of thyroid dysfunction in premature infants remains controversial. Furthermore, it is unknown whether untreated thyroid dysfunction in premature babies affects neurodevelopmental outcome. In the vast majority of preterm infants, hypothyroxinaemia is transient; however, permanent hypothyroidism due to thyroid dysgenesis or enzyme defects might also occur. Therefore, careful monitoring of thyroid function and long-term follow-up is needed to assess an appropriate therapeutic approach. This article reviews thyroid physiology in preterm infants, the influences of gestation and other neonatal conditions on thyroid function tests, optimal timing of screening and possible predictors to differentiate transient hypothyroxinaemia from permanent hypothyroidism. |
| Databáze: | OpenAIRE |
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