Development of delayed thyroid stimulating hormone elevation in small-for-gestational-age infants: is a second screening needed?

• Main Authors: Gahyun Lee (Author), So Yun Park (Author), Jae Hyun Park (Author), Seokjin Kang (Author)
• Format: Book
• Published: Korean Society of Pediatric Endocrinology, 2022-06-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2287-1012; 2287-1292; 10.6065/apem.2244002.001
• Keywords: congenital hypothyroidism; delayed thyrotropin elevation; levothy roxine; newborn thyroid screening; small for gestational age; Pediatrics; RJ1-570
• Source: Annals of Pediatric Endocrinology & Metabolism, Vol 28, Iss 1, Pp 42-48 (2022)

Purpose Recent reports indicate that small for gestational age (SGA) could be a risk factor for delayed thyroid stimulating hormone (dTSH) elevation in preterm infants. The development of dTSH elevation in SGA late-preterm infants with a gestational age of 34-36 weeks has been investigated in only a few studies. Methods In the present retrospective study, 70 SGA infants and 86 sex- and gestational age-matched controls who presented with normal results on initial thyroid function testing were included. Results SGA infants had a significantly higher prevalence of dTSH elevation (15.7% vs. 3.5%, P=0.009) compared with appropriate-for-gestational age infants. In SGA infants, the mean age at the time of dTSH was 24 days. Development of dTSH was associated with SGA and medical treatment with dopamine or furosemide. After adjusting for confounding factors, multiple logistic regression analysis showed SGA was a significant risk factor for the development of dTSH elevation (odds ratio, 23.2; 95% confidence interval, 2.27-236.91; P=0.008). Conclusions SGA infants may be at risk for dTSH and clinicians could consider a second thyroid screening test around the age of 1 month.