Association between congenital hypothyroidism and in-hospital adverse outcomes in very low birth weight infants
10.3760/cma.j.cn112140-20231012-00281
- VernacularTitle:极低出生体重儿先天性甲状腺功能减低症与住院期间不良结局的关系
- Author:
Sha ZHU
1
;
Jing XU
;
Ranran SHI
;
Xiaokang WANG
;
Maomao SUN
;
Shina LI
;
Lingling GAO
;
Yuanyuan LI
;
Huimin WEN
;
Changliang ZHAO
;
Shuai LI
;
Juan JI
;
Cuihong YANG
;
Yonghui YU
Author Information
1. 山东第一医科大学附属省立医院新生儿科，济南250014
- Keywords:
Infant, very low birth weight;
Congenital hypothyroidism;
Prognosis;
Cohort studies
- From:
Chinese Journal of Pediatrics
2024;62(1):29-35
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the association between congenital hypothyroidism (CH) and the adverse outcomes during hospitalization in very low birth weight infants (VLBWI).Methods:This prospective, multicenter observational cohort study was conducted based on the data from the Sino-northern Neonatal Network (SNN). Data of 5 818 VLBWI with birth weight <1 500 g and gestational age between 24-<37 weeks that were admitted to the 37 neonatal intensive care units from January 1 st, 2019 to December 31 st, 2022 were collected and analyzed. Thyroid function was first screened at 7 to 10 days after birth, followed by weekly tests within the first 4 weeks, and retested at 36 weeks of corrected gestational age or before discharge. The VLBWI were assigned to the CH group or non-CH group. Chi-square test, Fisher exact probability method, Wilcoxon rank sum test, univariate and multivariate Logistic regression were used to analyze the relationship between CH and poor prognosis during hospitalization in VLBWI. Results:A total of 5 818 eligible VLBWI were enrolled, with 2 982 (51.3%) males and the gestational age of 30 (29, 31) weeks. The incidence of CH was 5.5% (319 VLBWI). Among the CH group, only 121 VLBWI (37.9%) were diagnosed at the first screening. Univariate Logistic regression analysis showed that CH was associated with increased incidence of extrauterine growth retardation (EUGR) ( OR=1.31(1.04-1.64), P<0.05) and retinopathy of prematurity (ROP) of stage Ⅲ and above ( OR=1.74(1.11-2.75), P<0.05). However, multivariate Logistic regression analysis showed no significant correlation between CH and EUGR, moderate to severe bronchopulmonary dysplasia, grade Ⅲ to Ⅳ intraventricular hemorrhage, neonatal necrotizing enterocolitis in stage Ⅱ or above, and ROP in stage Ⅲ or above ( OR=1.04 (0.81-1.33), 0.79 (0.54-1.15), 1.15 (0.58-2.26), 1.43 (0.81-2.53), 1.12 (0.70-1.80), all P>0.05). Conclusion:There is no significant correlation between CH and in-hospital adverse outcomes, possibly due to timely diagnosis and active replacement therapy.
