Frequency of transient hypothyroxinaemia in low birthweight infants. Potential pitfall for neonatal screening programmes

Abstract

Thyroid function was studied in 54 low birthweight infants during a 3-week period. Each infant was placed in one of three groups. Group 1 (n = 21), infants who were well and appropriately grown for gestational age; group 2 (n = 23), infants who were appropriately grown but who had hyaline membrane disease; group 3 (n = 10), infants who were small for-gestational-age. In group 1, 5 (24%) infants had at least one serum thyroxine value <3.0 μg/100 ml (39 nmol/l). There were 8 (35%) infants in grou p 2 who had similarly low serum thyroxine values, as did 5 (50%) of the 10 infants in group 3. Serum thyrotropin levels and serum binding of thyroid hormones, as measured by a T3-charcoal uptake test, were normal in all infants. In all instances but 2, serum thyroxine values were at least 4.0 μg/100 ml (51 nmol/l) by the end of the 3-week period. There is thus a high incidence of transient 'hypothyroxinaemia' in low birthweight infants, particularly if such infants have hyaline membrane disease or are small-for-gestational-age. These findings must be considered when interpreting results of screening programmes for congenital hypothyroidism and they lend further support to the use of a combination of serum thyroxine and thyrotropin determinations for optimum screening of such infants.