본문 바로가기
KERD
논문KCI 등재

Screening and management of thyroid dysfunction in preterm infants

2

조회

0

다운로드

3

인용

0

참고문헌

키워드

주제분류소아과학

초록

Preterm infants can suffer various thyroid dysfunctions associated with developmental immaturity of the hypothalamic-pituitary-thyroid axis, postnatal illness, medications, or iodine supply. The incidence of thyroid dysfunction among preterm infants is higher than that among term infants and has been increasing with improvement in the survival of preterm infants. Hypothyroxinemia is frequently observed during the first week of life in extreme preterm neonates, and the incidence of delayed thyrotropin elevation is high at the age of 2–6 weeks. Although the necessity of routine rescreening remains controversial, recent guidelines on screening for congenital hypothyroidism have recommended rescreening of all preterm neonates. Thyroid hormone replacement is recommended for persistent thyrotropin elevation with or without hypothyroxinemia. Hypothyroxinemia without thyrotropin elevation does not require treatment, and some potential risks of levothyroxine supplementation have been reported. Although most thyroid dysfunctions are transient, careful follow-up after discontinuation of levothyroxine is considered so as to avoid missing persistent hypothyroidism.

Abstract

Preterm infants can suffer various thyroid dysfunctions associated with developmental immaturity of the hypothalamic-pituitary-thyroid axis, postnatal illness, medications, or iodine supply. The incidence of thyroid dysfunction among preterm infants is higher than that among term infants and has been increasing with improvement in the survival of preterm infants. Hypothyroxinemia is frequently observed during the first week of life in extreme preterm neonates, and the incidence of delayed thyrotropin elevation is high at the age of 2–6 weeks. Although the necessity of routine rescreening remains controversial, recent guidelines on screening for congenital hypothyroidism have recommended rescreening of all preterm neonates. Thyroid hormone replacement is recommended for persistent thyrotropin elevation with or without hypothyroxinemia. Hypothyroxinemia without thyrotropin elevation does not require treatment, and some potential risks of levothyroxine supplementation have been reported. Although most thyroid dysfunctions are transient, careful follow-up after discontinuation of levothyroxine is considered so as to avoid missing persistent hypothyroidism.

참고문헌 (60)

  1. Dussault JH, "Preliminary report on a mass screening program for neonatal hypothyroidism", J Pediatr, 86, pp.670~674 (1975)
  2. 이동환, "한국 소아 내분비 및 대사질환의 역학", Clinical and Experimental Pediatrics, 51(6), pp.559~563 (2008), 대한소아청소년과학회
  3. Mitchell ML, "Unresolved issues in the wake of newborn screening for congenital hypothyroidism", J Pediatr, 173, pp.228~231.e1 (2016)
  4. American Academy of Pediatrics, "Update of newborn screening and therapy for congenital hypothyroidism", Pediatrics, 117, pp.2290~2303 (2006)
  5. Léger J, "European Society for Paediatric Endocrinology consensus guidelines on screening, diagnosis, and management of congenital hypothyroidism", Horm Res Paediatr, 81, pp.80~103 (2014)
  6. Mass Screening Committee, "Guidelines for mass screening of congenital hypothyroidism (2014revision)", Clin Pediatr Endocrinol, 24, pp.107~133 (2015)
  7. Desai MP, "Newborn screening guidelines for congenital hypothyroidism in India: recommendations of the Indian Society for Pediatric and Adolescent Endocrinology (ISPAE) - Part I: Screening and Confirmation of Diagnosis", Indian J Pediatr, 85, pp.440~447 (2018)
  8. Uhrmann S, "Thyroid function in the preterm infant: a longitudinal assessment", J Pediatr, 92, pp.968~973 (1978)
  9. Hillman NH, "Physiology of transi-tion from intrauterine to extrauterine life", Clin Perinatol, 39, pp.769~783 (2012)
  10. Fisher DA, "Thyroid system immaturities in very low birth weight premature infants", Semin Perinatol, 32, pp.387~397 (2008)
  11. Mandel SJ, "Atypical hypothyroidism and the very low birthweight infant", Thyroid, 10, pp.693~695 (2000)
  12. Scratch SE, "Free thyroxine levels after very preterm birth and neurodevelopmental outcomes at age 7years", Pediatrics, 133, pp.e955~e963 (2014)
  13. Jacobsen BB, "Serum concentrations of thyroxine-binding globulin, prealbumin and albumin in healthy fullterm, small-for-gestational age and preterm newborn infants", Acta Paediatr Scand, 68, pp.49~55 (1979)
  14. Delahunty C, "Levels of neonatal thyroid hormone in preterm infants and neurodevelopmental outcome at 5 1", 2years: millennium cohort study, 2010, pp.95, 4898~4908
  15. van Wassenaer AG, "Effects of thyroxine supplementation on neurologic development in infants born at less than 30weeks' gestation", N Engl J Med, 336, pp.21~26 (1997)
  16. Briët JM, "Neonatal thyroxine supplementation in very preterm children: developmental outcome evaluated at early school age", Pediatrics, 107, pp.712~718 (2001)
  17. van Wassenaer AG, "Ten-year follow-up of children born at <30 weeks' gestational age supplemented with thyroxine in the neonatal period in a randomized, controlled trial", Pediatrics, 116, pp.e613~e618 (2005)
  18. van Wassenaer-Leemhuis A, "Thyroid hormone supplementation in preterm infants born before 28 weeks gestational age and neurodevelopmental outcome at age 36 months", Thyroid, 24, pp.1162~1169 (2014)
  19. Iijima S, "Current knowledge of transient hypothyroxinemia of prematurity: to treat or not to treat?", J Matern Fetal Neonatal Med, pp.1~7 (2018)
  20. Yamamoto A, "Response to thyrotropin-releasing hormone stimulation tests in preterm infants with transient hypothyroxinemia of prematurity", J Perinatol, 35, pp.725~728 (2015)
  21. Larson C, "Risk factors associated with delayed thyrotropin elevations in congenital hypothyroidism", J Pediatr, 143, pp.587~591 (2003)
  22. Cavarzere P, "Congenital hypothyroidism with delayed TSH elevation in low-birth-weight infants:incidence, diagnosis and management", Eur J Endocrinol, 175, pp.395~402 (2016)
  23. 정혜림, "High Incidence of Thyroid Dysfunction in Preterm Infants", Journal of Korean Medical Science, 24(4), pp.627~631 (2009), 대한의학회
  24. 이지훈, "Thyroid dysfunction in very low birth weight preterm infants", Clinical and Experimental Pediatrics, 58(6), pp.224~229 (2015), 대한소아청소년과학회
  25. Woo HC, "Congenital hypothyroidism with a delayed thyroid-stimulating hormone elevation in very premature infants:incidence and growth and developmental outcomes", J Pediatr, 158, pp.538~542 (2011)
  26. Hollanders JJ, "No association between transient hypothyroxinemia of prematurity and neurodevelopmental outcome in young adulthood", J Clin Endocrinol Metab, 100, pp.4648~4653 (2015)
  27. Williams FL, "Developmental trends in cord and postpartum serum thyroid hormones in preterm infants", J Clin Endocrinol Metab, 89, pp.5314~5320 (2004)
  28. Kester MH, "Iodothyronine levels in the human developing brain: major regulatory roles of iodothyronine deiodinases in different areas", J Clin Endo-crinol Metab, 89, pp.3117~3128 (2004)
  29. Fisher DA, "Physiological variations in thyroid hormones:physiological and pathophysiological considerations", Clin Chem, 42, pp.135~139 (1996)
  30. Ares S, "Thyroid gland volume as measured by ultrasonography in preterm infants", Acta Paediatr, 84, pp.58~62 (1995)
  31. Zung A, "Risk factors for the develop-ment of delayed TSH elevation in neonatal intensive care unit newborns", J Clin Endocrinol Metab, 102, pp.3050~3055 (2017)
  32. Delange F, "Optimal iodine nutrition during pregnancy, lactation and the neonatal period", Int J Endocrinol Metab, 2, pp.1~12 (2004)
  33. Delange F, "Iodine requirements during pregnancy, lactation and the neonatal period and indicators of optimal iodine nutrition", Public Health Nutr, 10(12A), pp.1571~1580 (2007)
  34. Ares S, "Neonatal hypothyroxinemia: effects of iodine intake and premature birth", J Clin Endocrinol Metab, 82, pp.1704~1712 (1997)
  35. Ibrahim M, "Iodine deficiency associated with parenteral nutrition in extreme preterm infants", Arch Dis Child Fetal Neonatal Ed, 88, pp.F56~F57 (2003)
  36. Linder N, "Topical iodine-containing antiseptics and subclinical hypothyroidism in preterm infants", J Pediatr, 131, pp.434~439 (1997)
  37. Smith VC, "Hypothyroidism in a breast-fed preterm infant resulting from maternal topical iodine exposure", J Pediatr, 149, pp.566~567 (2006)
  38. Chung HR, "Subclinical hypothyroidism in Korean preterm infants associated with high levels of iodine in breast milk", J Clin Endocrinol Metab, 94, pp.4444~4447 (2009)
  39. Melmed S, "Williams textbook of endocrinology", pp.334~335 (2015), Saunders Elsevier
  40. Moon S, "Iodine content of human milk and dietary iodine intake of Korean lactating mothers", Int J Food Sci Nutr, 50, pp.165~171 (1999)
  41. Aitken J, "A systematic review of thyroid dys-function in preterm neonates exposed to topical iodine", Arch Dis Child Fetal Neonatal Ed, 99, pp.F21~F28 (2014)
  42. Ghirri P, "Iodine supplementation in the newborn", Nutrients, 6, pp.382~390 (2014)
  43. Agostoni C, "Enteral nutrient supply for pre-term infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition", J Pediatr Gastroenterol Nutr, 50, pp.85~91 (2010)
  44. Zimmermann MB, "Iodine in enteral and paren-teral nutrition", Best Pract Res Clin Endocrinol Metab, 24, pp.143~158 (2010)
  45. Greene HL, "Guidelines for the use of vitamins, trace elements, calcium, magnesium, and phosphorus in infants and children receiving total parenteral nutrition: report of the Subcommittee on Pediatric Parenteral Nutrient Requirements from the Committee on Clinical Practice Issues of the American Society for Clinical Nutrition", Am J Clin Nutr, 48, pp.1324~1342 (1988)
  46. Koletzko B, "Guidelines on Paediatric Parenteral Nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), Supported by the European Society of Paediatric Research (ESPR)", J Pediatr Gastroenterol Nutr, 41(Suppl 2), pp.S1~S87 (2005)
  47. "A labora-tory guide to newborn screening in the UK for congenital hypothyroidism" (2014)[URL]
  48. Vincent MA, "Very low birth weight newborns do not need repeat screening for congenital hypothyroidism", J Pediatr, 140, pp.311~314 (2002)
  49. "Thyroid physiology and screening in preterm infants" (2018)[URL]
  50. Korada M, "Repeat testing for congenital hypothy-roidism in preterm infants is unnecessary with an appropriate thyroid stimulating hormone threshold", Arch Dis Child Fetal Neonatal Ed, 93, pp.F286~F288 (2008)
  51. Clark SJ, "Reference ranges for thyroid function tests in premature infants beyond the first week of life", J Perinatol, 21, pp.531~536 (2001)
  52. Yagasaki H, "Late-onset circulatory dysfunction after thyroid hormone treatment in an extremely low birth weight infant", J Pediatr Endocrinol Metab, 23, pp.153~158 (2010)
  53. Kawai M, "Nationwide surveillance of circulatory collapse associated with levothyroxine administration in very-low-birthweight infants in Japan", Pediatr Int, 54, pp.177~181 (2012)
  54. Shimokaze T, "Increased incidence of late-onset circulatory collapse after changing clinical practice:a retrospective investigation of causative factors", Am J Perinatol, 32, pp.1169~1176 (2015)
  55. 이진아, "재태주령 32주 이하 미숙아에서 생후 1주 이후 후기 저혈압 및 부신 기능부전과의 관계", Neonatal medicine, 18(2), pp.211~220 (2011), 대한신생아학회
  56. 이운지, "Clinical Features of Late-onset Circulatory Collapse in Preterm Infants", Perinatology, 24(3), pp.148~157 (2013), 대한주산의학회
  57. Lim G, "Early discontinuation of thyroxine therapy is possible in most very low-birthweight infants with hypothyroidism detected by screening", Acta Paediatr, 103, pp.e123~e129 (2014)
  58. Jung JM, "Feasibility of an early discon-tinuation of thyroid hormone treatment in very-low-birth-weight infants at risk for transient or permanent congenital hypothyroidism", Horm Res Paediatr, 85, pp.131~139 (2016)
  59. Vigone MC, "Evolution of thyroid function in preterm infants detected by screening for congenital hypothyroidism", J Pediatr, 164, pp.1296~1302 (2014)
  60. Oh KW, "Establishing a reference range for triiodothyronine levels in preterm infants", Early Hum Dev, 90, pp.621~624 (2014)

이 간행물의 다른 논문 (11건)