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Ann Pediatr Endocrinol Metab > Volume 28(1); 2023 > Article
DOI: https://doi.org/10.6065/apem.2244002.001    Published online June 28, 2022.
Development of delayed thyroid stimulating hormone elevation in small-for-gestational-age infants: is a second screening needed?
Gahyun Lee1  , So Yun Park2  , Jae Hyun Park1  , Seok Jin Kang2 
1Department of Pediatrics, Keimyung University Dongsan Hospital, Daegu, Korea
2Department of Pediatrics, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea, Daegu, Korea
Address for correspondence:  Seok Jin Kang
Email: pedjin625@gmail.com
Received: January 4, 2022   Revised: February 18, 2022   Accepted: March 11, 2022
Abstract
Purpose
Recent reports indicate that small for gestational age (SGA) could be a risk factor for delayed thyroid stimulating hormone (dTSH) elevation in preterm infants. The development of dTSH elevation in SGA late-preterm infants with a gestational age of 34–36 weeks has been investigated in only a few studies.
Methods
In the present retrospective study, 70 SGA infants and 86 sex- and gestational age-matched controls who presented with normal results on initial thyroid function testing were included.
Results
SGA infants had a significantly higher prevalence of dTSH elevation (15.7% vs. 3.5%, P=0.009) compared with appropriate-for-gestational age infants. In SGA infants, the mean age at the time of dTSH was 24 days. Development of dTSH was associated with SGA and medical treatment with dopamine or furosemide. After adjusting for confounding factors, multiple logistic regression analysis showed SGA was a significant risk factor for the development of dTSH elevation (odds ratio, 23.2; 95% confidence interval, 2.27–236.91; P=0.008).
Conclusion
SGA infants may be at risk for dTSH and clinicians could consider a second thyroid screening test around the age of 1 month.
Keywords: Congenital hypothyroidism, Delayed thyrotropin elevation, Levothy roxine, Newborn thyroid screening, Small for gestational age
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