DOI 10.1515/jpem-2013-0243      J Pediatr Endocr Met 2014; 27(5-6): 425–430

Renee M. Behme, Amy B. Mackley, Louis Bartoshesky and David A. Paul*

Thyroid function in late preterm infants in relation to mode of delivery and respiratory support Abstract: The relationship between thyroid function, mode of delivery, and illness in infants 34–36 weeks’ gestation has not been well studied. We hypothesized that infants born by cesarean delivery and those with increased illness would have a reduction in thyroxine (T4) following birth. Total T4 and thyroid-stimulating hormone were obtained at birth (Time 1) and between days 2 and 5 (Time 2). The study sample included 129 infants 34–36 weeks’ gestation. There were no differences in total T4 between infants born by cesarean or vaginal delivery (p = 0.18), or between those requiring respiratory support compared to infants not requiring respiratory support (p = 0.09). At Time 2, 93% of the study population had a total T4 below one standard error of the reference laboratory mean. In our study sample, despite many infants having a low total T4, there was no association between total T4 levels, respiratory support, or mode of delivery. Keywords: hypothyroxinemia; illness severity; late preterm; prematurity; respiratory distress. Clinicaltrials.gov: NCT00971555. *Corresponding author: David A. Paul, Neonatology, Christiana Hospital, MAP 1, 217, 4745 Ogletown Stanton Rd, Newark, DE 19713, USA, Phone: +1 302 733 2410, E-mail: [email protected] Renee M. Behme: Neonatology, Capital Health Medical Center, 750 Brunswick Avenue, Trenton, NJ 08638, NJ, USA Amy B. Mackley and Louis Bartoshesky: Department of Pediatrics, Christiana Care Health Services, 4745 Ogletown Stanton Rd, Newark, DE 19713, USA

Introduction Transient hypothyroxinemia is a condition characterized by low levels of serum thyroxine (T4) and normal levels of thyroid-stimulating hormone (TSH). Transient hypothyroxinemia is common in premature infants and thought to be related to multiple factors including, but not limited to, hypothalamic-pituitary-thyroid immaturity (1). Transient hypothyroxinemia in premature infants has been found to be related to severity of illness, reflecting a process similar to “euthyroid sick syndrome” as

described in adults (2). T4 levels in very low birth weight infants (VLBW,  

Thyroid function in late preterm infants in relation to mode of delivery and respiratory support.

The relationship between thyroid function, mode of delivery, and illness in infants 34-36 weeks' gestation has not been well studied. We hypothesized ...
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