Thyroid function disorders in low birth weight/preterm neonates admitted in NICU, Children Hospital Complex Multan.

Abstract

Objectives: Congenital hypothyroidism (CHT) is one of the major endocrine and metabolic disorders in neonates. Delayed diagnosis and treatment of CHT may lead to certain neuro-developmental disorders. Study Design: Prospective study. Setting: NICU of Children Hospital, Institute of Child Health Multan, Pakistan. Period: September 2018 to November 2019. Material & Methods: A total of 142 neonates of both gender having birth weight of less than 1500 grams were enrolled in this study. Thyroid function tests, like TSH, free T4 and T4 levels were performed in all these neonates between 1- 5^th day, 2^nd week and 4^th week of life by radioimmunoassay. Results: Out of 142 neonates, 76 (53.5%) were male and 66 (46.5%) female. Mean gestational age was 31.41+1.93 weeks while mean birth weight was found to be 1261.53 + 170.36 grams. Gestational age of < 28 weeks was noted in 9 (6.3%) neonates, 28 to <30 weeks in 59 (40.4%), 30 to 32 weeks in 33 (23.2%) and 41 (28.9%) were above 32 weeks. Thyroid function disorders were noted in 89 (62.7%) neonates while transient hypothyroxinemia was the most common one, found in 65 (45.7%) neonates, transient hyperthyroxinemia in 12 (8.4%) and Congenital hypothyroidism (CHT) in 12 (8.4%). Nasal continuous positive airway pressure (NCPAP) was used for treating respiratory distress syndrome (RDS) in 107 (75.4%) neonates. Surfactant administration was done in 69 (48.6%). Patent ductus arteriosis (PDA) was noted in 27 (19.0%), intraventricular hemorrhage (IVH) in 8 (5.6%) and culture proven sepsis was seen in 18 (12.7%). Conclusion: In low birth weight / preterm neonates, thyroid function disorders are quite common. Transient Hypothyroxinemia was noted to be the most common disorder and congenital hypothyroidism was present in 8.4% of neonates.