| Description |
- Background: Congenital hypothyroidism is the most common congenital endocrine disorder, and is one of the most common and preventable causes of intellectual disability. Preterm infants with low birth weights are more likely to develop congenital hypothyroidism of prematurity (CHP) due to their developmental immaturity. However, the epidemiology and clinical characteristics of CHP in very-low-birth-weight (VLBW) infants are poorly described.
Methods: Demographics, clinical characteristics, and outcomes were compared between VLBW infants with and without CHP. Multivariable logistic regression analyses were also performed to determine associations between maternal- and infant-related factors and odds of developing CHP.
Results: Of the 728 VLBW infants, 61 (8.4%) had CHP. The incidence in VLBW infants with birth weight under 1000 grams (67.2%) was higher than in infants with birth weight between 1000 and 1500 grams (32.8%). The majority of CHP manifested as abnormal thyroid function after two weeks of postnatal age and the mean age of thyroxine treatment initiation was 36 postnatal days. Greater maternal age, cesarean section delivery, lower birth weight, and small for gestational age (SGA) size were associated with and led to increased odds of CHP in VLBW infants. These infants were significantly more likely to have had respiratory distress syndrome, persistent ductus arteriosus, and chronic lung disease at 36 weeks gestation. They also had worse outcomes, including greater total days of assisted ventilation and duration of hospitalization.
Conclusions: As compared to VLBW infants without CHP, infants diagnosed with CHP are more likely to have lower birth weight and SGA and be born by cesarean section to mothers of greater age. Such infants have significantly higher early and late morbidities. Further studies are needed to optimize the screening strategy in this high-risk population.
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