Preterm yenidoğanlarda gebelik yaşına göre küçük olmak ile tiroid fonksiyon testleri arasındaki ilişki
Öz
Amaç: Bu çalışmada erken doğmuş, gebelik yaşına göre küçük (SGA) bebeklerde tiroid hormon düzeyleri ile klinik sonuçlar arasındaki ilişkiyi değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Prematüre yenidoğanlar (gebelik yaşı ≤30 hafta) SGA olan ve olmayan olarak iki gruba ayrıldı. Gruplar arasında tiroid uyarıcı hormon (TSH) ve serbest tiroksin (sT4) düzeyleri, konjenital hipotiroidizm (KH) sıklığı, demografik ve klinik özellikler, morbidite ve mortalite oranları karşılaştırıldı.
Bulgular: SGA grubunda 72 ve SGA olmayan grupta 358 olmak üzere toplam 430 prematüre yenidoğan dahil edildi. KH sıklığı, morbidite, demografik ve klinik özellikler iki grup arasında benzerdi. Mortalite oranı SGA'da (%36,1) SGA olmayan gruptan (%13,6) daha yüksekti. Serum sT4 düzeyi SGA grubunda (1,04±0,30 ng/dl) SGA olmayan gruba göre (1,24±0,33 ng/dl) daha düşüktü. Serum TSH düzeyi SGA grubunda (9,91 ± 5,6 uIU/L), SGA olmayan gruptan (6,6 ± 5,2 uIU/L) daha yüksekti.
Sonuç: Tiroid disfonksiyonu sıklığı, geçici olarak yüksek TSH ve düşük fT4 konsantrasyonlarına bağlı olarak, preterm SGA bebeklerde SGA olmayanlara kıyasla daha yüksekti. Bu nedenle erken doğmuş ve SGA bebeklerde tiroid fonksiyon testleri periyodik olarak izlenmelidir.
Anahtar Kelimeler
serbest tiroksin bebek prematüre gebelik yaşına göre küçük bebek tiroid uyarıcı hormone
Destekleyen Kurum
Yok
Proje Numarası
Yok
Teşekkür
Yok
Kaynakça
- Referans1. Batchelor M, Brown SJ, Glover K, Gartland D. A systematic review of child health and developmental outcomes associated with low birthweight and/or small for gestational age in indigenous children from Australia, Canada and New Zealand. Int J Environ Res Public Health. 2021;18:12669.
- Referans2. Kaluarachchi DC, Nicksic VB, Allen DB, Eickhoff JC, Baker MW, Kling PJ. Thyroid hormone function in small for gestational age term newborns. J Pediatr. 2021;238:181-186.e3.
- Referans3. Ludvigsson JF, Lu D, Hammarström L, Cnattingius S, Fang F. Small for gestational age and risk of childhood mortality: A Swedish population study. PLoS Med. 2018;15:e1002717.
- Referans4. Ceran B, Beşer E, Karaçağlar NB, Beyoğlu R, Şimşek GK, Canpolat FE, et al. Evaluation of the correlation of the new Ballard scoring with the ultrasonographic optical nerve sheath diameter and brain volume of preterm infants. Early Hum Dev. 2021;163:105506.
- Referans5. Liu C, Wang K, Guo J, Chen J, Chen M, Xie Z, et al. Small for gestational age is a risk factor for thyroid dysfunction in preterm newborns. BMC Pediatr. 2020;20:179.
- Referans6. Çakır U, Tayman C. The effect of thyroid functions on osteopenia of prematurity in preterm infants. J Pediatr Endocrinol Metab. 2019;32:65-70.
- Referans7. Çakır U, Tayman C. Çok düşük doğum ağırlıklı prematürelerde konjenital hipotiroidi ile mortalite ilişkisinin değerlendirilmesi. Jinekoloji - Obstetrik ve Neonatoloji Tıp Dergisi 2019; 16:122-5.
- Referans8. Çakır U, Yakut Hİ, Tayman C. Çok düşük doğum ağırlıklı prematürelerde konjenital hipotiroidi ile intraventriküler kanama ilişkisinin değerlendirilmesi. Türkiye Çocuk Hast Derg. 2019;2:45-9.
- Referans9. Çakır U, Tayman C, Özer Bekmez B, Büyüktiryaki M, Yarcı E. Çok düşük doğum ağırlıklı yenidoğanlarda konjenital hipotiroidi ve respiratuvar distres sendromu ilişkisinin araştırılması. Ankara Üniv Tıp Fak Mecm. 2019;72:362-6.
- Referans10. Çakır U, Tayman C, Büyüktiryaki M. Çok düşük doğum ağırlıklı yenidoğanlarda konjenital hipotiroidi ve prematüre retinopatisi ilişkisinin araştırılması. KÜ Tıp Fak Derg. 2018;20:232-40.
- Referans11.Çakır U, Tayman C, Yakut Hİ, Yarcı E. Çok düşük doğum ağırlıklı prematüre infantlarda tiroid fonksiyonlarının değerlendirilmesi. Türkiye Çocuk Hast Derg. 2019;3:165-70.
- Referans12.Franco B, Laura F, Sara N, Salvatore G. Thyroid function in small for gestational age newborns: a review. J Clin Res Pediatr Endocrinol. 2013;5 Suppl 1:2-7.
- Referans13. Bosch-Giménez VM, Palazón-Bru A, Blasco-Barbero Á, Juste-Ruiz M, Rizo-Baeza MM, Cortés-Castell E. Multivariate analysis of thyrotropin in preterm newborns based on adequacy of weight for gestational age. Thyroid 2017; 27:120-124.
- Referans14. Cakir U, Tayman C, Buyuktiryaki M. An unknown risk factor for sepsis in very low birth weight preterms: ABO blood groups (BGaPS Study). Am J Perinatol. 2021;38:669-75.
- Referans15. Bozkaya D, Ceran B, Ozmen E, Okman E, Dizdar EA, Oguz SS, et al. A new hope in the treatment of intraventricular haemorrhage in preterm infants: mesenchymal stem cells. Turk Neurosurg. 2022;32:344-6.
- Referans16. Cakir U, Tayman C, Karacaglar NB, Beser E, Ceran B, Unsal H. Comparison of the effect of continuous and standard intermittent bolus paracetamol infusion on patent ductus arteriosus. Eur J Pediatr. 2021;180:433-40.
- Referans17. Cakir U, Tayman C, Yucel C, Ozdemir O. Can IL-33 and Endocan be new markers for retinopathy of prematurity? Comb Chem High Throughput Screen. 2019;22:41-8.
- Referans18. Cakir U, Tayman C, Yucel C. A novel diagnostic marker for the severity of bronchopulmonary dysplasia in very low birth weight infants: Interleukin-33. Pediatr Allergy Immunol Pulmonol. 2019;32:12-7.
- Referans19. Cakir U, Tayman C, Yarci E, Halil H, Buyuktiryaki M, Ulu HO, et al. Novel useful markers for follow-up of necrotizing enterocolitis: endocan and interleukin-33. J Matern Fetal Neonatal Med. 2020;33:2333-41.
- Referans20. Bozkaya D, Dizdar EA, Korkut S, Ceran B, Alkan M, Oğuz ŞS. Evaluation of different types of natural surfactants by lung ultrasound in respiratory distress syndrome. Am J Perinatol. 2021;38:590-6.
- Referans21. Çakır U, Tayman C. The effect of thyroid functions on osteopenia of prematurity in preterm infants. J Pediatr Endocrinol Metab. 2019;32:65-70.
- Referans22. Grob F, Gutiérrez M, Leguizamón L, Fabres J. Hyperthyrotropinemia is common in preterm infants who are born small for gestational age. J Pediatr Endocrinol Metab. 2020;33:375-82.
- Referans23. Franco B, Farmeschi, L, Peruzzi L, Musarò A, Paffetti P, Badii S, et al. Altered thyroid function in small for gestational age newborns: study based on screening test for congenital hypothyroidism. Journal of Pediatric Sciences. 2010;4:e55.
- Referans24. Uchiyama A, Watanabe H, Nakanishi H, Totsu S. Small for gestational age is a risk factor for the development of delayed thyrotropin elevation in infants weighing less than 2000 g. Clin Endocrinol (Oxf). 2018;89:431-36.
- Referans25. Kaluarachchi DC, Colaizy TT, Pesce LM, Tansey M, Klein JM. Congenital hypothyroidism with delayed thyroid-stimulating hormone elevation in premature infants born at less than 30 weeks gestation. J Perinatol. 2017;37:277-82.
- Referans26. Thorpe-Beeston JG, Nicolaides KH, Snijders RJ, Felton CV, McGregor AM. Thyroid function in small for gestational age fetuses. Obstet Gynecol 1991; 77:701-706.
- Referans27. Radetti G, Renzullo L, Gottardi E, D'Addato G, Messner H. Altered thyroid and adrenal function in children born at term and preterm, small for gestational age. J Clin Endocrinol Metab 2004; 89:6320-6324.
- Referans28. de Kort SW, Willemsen RH, van der Kaay DC, van Dijk M, Visser TJ, Hokken-Koelega AC. Thyroid function in short children born small-for-gestational age (SGA) before and during GH treatment. Clin Endocrinol (Oxf). 2008;69:318-22.
- Referans29. Trumpff C, De Schepper J, Vanderfaeillie J, et al. Thyroid-Stimulating Hormone (TSH) Concentration at Birth in Belgian Neonates and Cognitive Development at Preschool Age. Nutrients. 2015;7:9018-32.
- Referans 30. Chung ML, Yoo HW, Kim KS, Lee BS, Pi SY, Lim G, et al. Thyroid dysfunctions of prematurity and their impacts on neurodevelopmental outcome. J Pediatr Endocrinol Metab. 2013;26:449-55.
Öz
Purpose: The aim of this study was to evaluate the relationship between thyroid hormone levels and clinical outcomes in preterm, small for gestational age (SGA) infants.
Materials and Methods: The premature newborns (gestational age of ≤30 weeks) were divided into two groups as SGA and non-SGA. Thyroid stimulating hormone (TSH) and free thyroxine (fT4) levels, the frequency of congenital hypothyroidism (CH), demographic and clinical characteristics, morbidity and mortality rate were compared between the groups.
Results: A total of 430 premature newborns, 72 in the SGA group and 358 in the non-SGA group were included. The frequency of CH, morbidity, demographic and clinical characteristics were similar between two groups. The mortality rate was higher in SGA (36.1%) than in non-SGA group (13.6%). Serum fT4 level was lower in SGA group (1.04±0.30 ng/dl) compared to the non-SGA group (1.24±0.33 ng/dl). The serum TSH level was higher in SGA group (9.91 ± 5.6 uIU/L) than in non-SGA group (6.6 ± 5.2 uIU/L).
Conclusion: The frequency of thyroid dysfunction was higher in preterm SGA infants compared to non-SGA, which was due to transiently high TSH and low fT4 concentrations. Therefore, thyroid function tests should be monitored periodically in preterm and SGA infants.
Anahtar Kelimeler
free thyroxine infant premature small for gestational age thyroid stimulating hormone
Proje Numarası
Yok
Kaynakça
- Referans1. Batchelor M, Brown SJ, Glover K, Gartland D. A systematic review of child health and developmental outcomes associated with low birthweight and/or small for gestational age in indigenous children from Australia, Canada and New Zealand. Int J Environ Res Public Health. 2021;18:12669.
- Referans2. Kaluarachchi DC, Nicksic VB, Allen DB, Eickhoff JC, Baker MW, Kling PJ. Thyroid hormone function in small for gestational age term newborns. J Pediatr. 2021;238:181-186.e3.
- Referans3. Ludvigsson JF, Lu D, Hammarström L, Cnattingius S, Fang F. Small for gestational age and risk of childhood mortality: A Swedish population study. PLoS Med. 2018;15:e1002717.
- Referans4. Ceran B, Beşer E, Karaçağlar NB, Beyoğlu R, Şimşek GK, Canpolat FE, et al. Evaluation of the correlation of the new Ballard scoring with the ultrasonographic optical nerve sheath diameter and brain volume of preterm infants. Early Hum Dev. 2021;163:105506.
- Referans5. Liu C, Wang K, Guo J, Chen J, Chen M, Xie Z, et al. Small for gestational age is a risk factor for thyroid dysfunction in preterm newborns. BMC Pediatr. 2020;20:179.
- Referans6. Çakır U, Tayman C. The effect of thyroid functions on osteopenia of prematurity in preterm infants. J Pediatr Endocrinol Metab. 2019;32:65-70.
- Referans7. Çakır U, Tayman C. Çok düşük doğum ağırlıklı prematürelerde konjenital hipotiroidi ile mortalite ilişkisinin değerlendirilmesi. Jinekoloji - Obstetrik ve Neonatoloji Tıp Dergisi 2019; 16:122-5.
- Referans8. Çakır U, Yakut Hİ, Tayman C. Çok düşük doğum ağırlıklı prematürelerde konjenital hipotiroidi ile intraventriküler kanama ilişkisinin değerlendirilmesi. Türkiye Çocuk Hast Derg. 2019;2:45-9.
- Referans9. Çakır U, Tayman C, Özer Bekmez B, Büyüktiryaki M, Yarcı E. Çok düşük doğum ağırlıklı yenidoğanlarda konjenital hipotiroidi ve respiratuvar distres sendromu ilişkisinin araştırılması. Ankara Üniv Tıp Fak Mecm. 2019;72:362-6.
- Referans10. Çakır U, Tayman C, Büyüktiryaki M. Çok düşük doğum ağırlıklı yenidoğanlarda konjenital hipotiroidi ve prematüre retinopatisi ilişkisinin araştırılması. KÜ Tıp Fak Derg. 2018;20:232-40.
- Referans11.Çakır U, Tayman C, Yakut Hİ, Yarcı E. Çok düşük doğum ağırlıklı prematüre infantlarda tiroid fonksiyonlarının değerlendirilmesi. Türkiye Çocuk Hast Derg. 2019;3:165-70.
- Referans12.Franco B, Laura F, Sara N, Salvatore G. Thyroid function in small for gestational age newborns: a review. J Clin Res Pediatr Endocrinol. 2013;5 Suppl 1:2-7.
- Referans13. Bosch-Giménez VM, Palazón-Bru A, Blasco-Barbero Á, Juste-Ruiz M, Rizo-Baeza MM, Cortés-Castell E. Multivariate analysis of thyrotropin in preterm newborns based on adequacy of weight for gestational age. Thyroid 2017; 27:120-124.
- Referans14. Cakir U, Tayman C, Buyuktiryaki M. An unknown risk factor for sepsis in very low birth weight preterms: ABO blood groups (BGaPS Study). Am J Perinatol. 2021;38:669-75.
- Referans15. Bozkaya D, Ceran B, Ozmen E, Okman E, Dizdar EA, Oguz SS, et al. A new hope in the treatment of intraventricular haemorrhage in preterm infants: mesenchymal stem cells. Turk Neurosurg. 2022;32:344-6.
- Referans16. Cakir U, Tayman C, Karacaglar NB, Beser E, Ceran B, Unsal H. Comparison of the effect of continuous and standard intermittent bolus paracetamol infusion on patent ductus arteriosus. Eur J Pediatr. 2021;180:433-40.
- Referans17. Cakir U, Tayman C, Yucel C, Ozdemir O. Can IL-33 and Endocan be new markers for retinopathy of prematurity? Comb Chem High Throughput Screen. 2019;22:41-8.
- Referans18. Cakir U, Tayman C, Yucel C. A novel diagnostic marker for the severity of bronchopulmonary dysplasia in very low birth weight infants: Interleukin-33. Pediatr Allergy Immunol Pulmonol. 2019;32:12-7.
- Referans19. Cakir U, Tayman C, Yarci E, Halil H, Buyuktiryaki M, Ulu HO, et al. Novel useful markers for follow-up of necrotizing enterocolitis: endocan and interleukin-33. J Matern Fetal Neonatal Med. 2020;33:2333-41.
- Referans20. Bozkaya D, Dizdar EA, Korkut S, Ceran B, Alkan M, Oğuz ŞS. Evaluation of different types of natural surfactants by lung ultrasound in respiratory distress syndrome. Am J Perinatol. 2021;38:590-6.
- Referans21. Çakır U, Tayman C. The effect of thyroid functions on osteopenia of prematurity in preterm infants. J Pediatr Endocrinol Metab. 2019;32:65-70.
- Referans22. Grob F, Gutiérrez M, Leguizamón L, Fabres J. Hyperthyrotropinemia is common in preterm infants who are born small for gestational age. J Pediatr Endocrinol Metab. 2020;33:375-82.
- Referans23. Franco B, Farmeschi, L, Peruzzi L, Musarò A, Paffetti P, Badii S, et al. Altered thyroid function in small for gestational age newborns: study based on screening test for congenital hypothyroidism. Journal of Pediatric Sciences. 2010;4:e55.
- Referans24. Uchiyama A, Watanabe H, Nakanishi H, Totsu S. Small for gestational age is a risk factor for the development of delayed thyrotropin elevation in infants weighing less than 2000 g. Clin Endocrinol (Oxf). 2018;89:431-36.
- Referans25. Kaluarachchi DC, Colaizy TT, Pesce LM, Tansey M, Klein JM. Congenital hypothyroidism with delayed thyroid-stimulating hormone elevation in premature infants born at less than 30 weeks gestation. J Perinatol. 2017;37:277-82.
- Referans26. Thorpe-Beeston JG, Nicolaides KH, Snijders RJ, Felton CV, McGregor AM. Thyroid function in small for gestational age fetuses. Obstet Gynecol 1991; 77:701-706.
- Referans27. Radetti G, Renzullo L, Gottardi E, D'Addato G, Messner H. Altered thyroid and adrenal function in children born at term and preterm, small for gestational age. J Clin Endocrinol Metab 2004; 89:6320-6324.
- Referans28. de Kort SW, Willemsen RH, van der Kaay DC, van Dijk M, Visser TJ, Hokken-Koelega AC. Thyroid function in short children born small-for-gestational age (SGA) before and during GH treatment. Clin Endocrinol (Oxf). 2008;69:318-22.
- Referans29. Trumpff C, De Schepper J, Vanderfaeillie J, et al. Thyroid-Stimulating Hormone (TSH) Concentration at Birth in Belgian Neonates and Cognitive Development at Preschool Age. Nutrients. 2015;7:9018-32.
- Referans 30. Chung ML, Yoo HW, Kim KS, Lee BS, Pi SY, Lim G, et al. Thyroid dysfunctions of prematurity and their impacts on neurodevelopmental outcome. J Pediatr Endocrinol Metab. 2013;26:449-55.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma |
| Yazarlar | |
| Proje Numarası | Yok |
| Yayımlanma Tarihi | 28 Aralık 2022 |
| Kabul Tarihi | 28 Kasım 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 47 Sayı: 4 |
