Background: Transient hypothyroxinaemia of prematurity (THOP) is a common condition of preterm infants whose causes remain unclear. We tested the hypothesis that THOP is associated with histological chorioamnionitis (HCA). Methods: Whole blood T-4 and TSH concentrations on day 4 and at 40 weeks' postmenstrual age (rtx-T4 and rtx-TSH), placental histology and illness severity were prospectively evaluated in 155 very low birth weight (VLBW) infants. Results: HCA-positive infants showed significantly decreased blood total T-4 concentrations on day 4, as compared to the HCA-negative population (P < 0.0001), along with comparable TSH, rtx-T-4, and rtx-TSH blood concentrations. None of the infants showed evidence of hypothyroidism during the study. A total T-4 <= 4.4 mu g/dL on postnatal day 4 identified HCA-positive newborns with 90.8%, sensitivity, 94.7%, specificity, 96.7% positive predictive and 85.7% negative predictive values. HCA ( OR: 32.19; 95% CI: 8.95 - 115.64), birth weight <= 880 g ( OR: 4.1; 1.15 - 14.64), and RDS ( OR: 3.71, 95% CI: 1.13 - 12.25) were independently associated with evidence of hypothyroxinaemia on day 4. Conclusion: Our findings indicate a previously unrecognized relationship between HCA and THOP, hence suggesting a predominant role for a fetal systemic inflammatory response syndrome in the pathogenesis of THOP.
Abstract BACKGROUND: Transient hypothyroxinaemia of prematurity (THOP) is a common condition of preterm infants whose causes remain unclear. We tested the hypothesis that THOP is associated with histological chorioamnionitis (HCA). METHODS: Whole blood T4 and TSH concentrations on day 4 and at 40 weeks' postmenstrual age (rtx-T4 and rtx-TSH), placental histology and illness severity were prospectively evaluated in 155 very low birth weight (VLBW) infants. RESULTS: HCA-positive infants showed significantly decreased blood total T4 concentrations on day 4, as compared to the HCA-negative population (P<0.0001), along with comparable TSH, rtx-T4, and rtx-TSH blood concentrations. None of the infants showed evidence of hypothyroidism during the study. A total T4 < or = 4.4 microg/dL on postnatal day 4 identified HCA-positive newborns with 90.8%, sensitivity, 94.7%, specificity, 96.7% positive predictive and 85.7% negative predictive values. HCA (OR: 32.19; 95% CI: 8.95-115.64), birth weight < or = 880 g (OR: 4.1; 1.15-14.64), and RDS (OR: 3.71, 95% CI: 1.13-12.25) were independently associated with evidence of hypothyroxinaemia on day 4. CONCLUSION: Our findings indicate a previously un-recognized relationship between HCA and THOP, hence suggesting a predominant role for a fetal systemic inflammatory response syndrome in the pathogenesis of THOP.
DE FELICE, C., Bagnoli, F., Toti, P., Musaro, M.A., Peruzzi, L., Paffetti, P., et al. (2005). Transient hypothyroxinemia of prematurity and histological chorioamnionitis. JOURNAL OF PERINATAL MEDICINE, 33(6), 514-518 [10.1515/JPM.2005.091].
Transient hypothyroxinemia of prematurity and histological chorioamnionitis
DE FELICE, C.;BAGNOLI, F.;TOTI, P.;PERUZZI, L.;PAFFETTI, P.;
2005-01-01
Abstract
Abstract BACKGROUND: Transient hypothyroxinaemia of prematurity (THOP) is a common condition of preterm infants whose causes remain unclear. We tested the hypothesis that THOP is associated with histological chorioamnionitis (HCA). METHODS: Whole blood T4 and TSH concentrations on day 4 and at 40 weeks' postmenstrual age (rtx-T4 and rtx-TSH), placental histology and illness severity were prospectively evaluated in 155 very low birth weight (VLBW) infants. RESULTS: HCA-positive infants showed significantly decreased blood total T4 concentrations on day 4, as compared to the HCA-negative population (P<0.0001), along with comparable TSH, rtx-T4, and rtx-TSH blood concentrations. None of the infants showed evidence of hypothyroidism during the study. A total T4 < or = 4.4 microg/dL on postnatal day 4 identified HCA-positive newborns with 90.8%, sensitivity, 94.7%, specificity, 96.7% positive predictive and 85.7% negative predictive values. HCA (OR: 32.19; 95% CI: 8.95-115.64), birth weight < or = 880 g (OR: 4.1; 1.15-14.64), and RDS (OR: 3.71, 95% CI: 1.13-12.25) were independently associated with evidence of hypothyroxinaemia on day 4. CONCLUSION: Our findings indicate a previously un-recognized relationship between HCA and THOP, hence suggesting a predominant role for a fetal systemic inflammatory response syndrome in the pathogenesis of THOP.File | Dimensione | Formato | |
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https://hdl.handle.net/11365/24056
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