Hypothyroxinemia of prematurity and the risk of cerebral white matter damage

• Published in: The Journal of pediatrics 1999-06, Vol.134 (6), p.706-711
• Main Authors: Leviton, Alan, Paneth, Nigel, Reuss, M.Lynne, Susser, Mervyn, Allred, Elizabeth N., Dammann, Olaf, Kuban, Karl, Van Marter, Linda J., Pagano, Marcello
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Brain - embryology; Brain - growth & development; Brain - pathology; Echoencephalography; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Gestational Age; Humans; Infant, Newborn; Infant, Premature - blood; Infant, Very Low Birth Weight; Intensive care medicine; Medical sciences; Odds Ratio; Placenta - pathology; Risk Factors; Severity of Illness Index; Thyroxine - blood; Ultrasonography, Prenatal
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(99)70285-4

Objective: Infants with hypothyroxinemia of prematurity (HOP) are at increased risk for neurodevelopmental dysfunction. Infants born near the end of the middle trimester are also at increased risk for an echolucency (EL) in the cerebral white matter, which reflects white matter damage and is the cranial ultrasound abnormality that best predicts neurodevelopmental dysfunction. We postulated that some of the increased risk of neurodevelopmental problems associated with HOP reflects an increased risk of EL. Study design: We studied 1414 infants weighing 500 to 1500 g who were born at 4 medical centers between 1991 and 1993. The infants had thyroxine blood levels measured during the first weeks of life, at least 1 of 3 cranial ultrasound scans performed at specified postnatal intervals, and their own and their mother’s hospital charts reviewed. Infants were classified by whether or not their first thyroxine level placed them in the lowest quartile among all infants in this sample (ie,