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Serum Thyroid Hormones in Preterm Infants and Relationships to Indices of Severity of Intercurrent Illness

Maternal and Child Health Sciences (J.S., C.D., R.H.) and Community Health Sciences (F.L.R.W., S.A.O.), University of Dundee, Dundee DD1 9SY, Scotland, United Kingdom; Department of Internal Medicine (H.v.T., T.J.V.), Erasmus University Medical School, 3000 DR Rotterdam, The Netherlands; and Nuclear Medicine Service (S.-Y.W.), VA Medical Center, University of California–Irvine Medical Center, Long Beach, California 90822-5201

Address all correspondence and requests for reprints to: Professor Robert Hume, Maternal and Child Health Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland, United Kingdom. E-mail: r.hume{at}dundee.ac.uk.

The purpose of this study was to relate severity of illness at 1, 7, 14, and 28 postnatal days in preterm infants groups, 23–27 (n = 73), 28–30 (n = 160), and 31–34 (n = 208) wk gestation, to the corresponding sera levels of T₄, free T₄, T₄-binding globulin, TSH, T₃, rT₃, and T₄ sulfate. The British Association of Perinatal Medicine and Neonatal Nurses Association 1992 scoring categories (published elsewhere) were used as an index of illness severity: level 1 (maximal intensive care) was compared with level 2 (high-dependency intensive care) combined with level 3 (special care); infants were scored on 1, 7, 14, and 28 postnatal days. In level 1 infants, there were significant reductions in T₃ at 7 d (28–30 wk), 14, and 28 d (23–27 and 28–30 wk); T₄ at 7, 14, and 28 d (23–27 wk); at 14 and 28 d (28–30 wk); and at 7 d (31–34 wk); and free T₄ at 14 d (23–27 wk). TSH was unchanged in all groups at all ages and with reductions in T₄ and T₃ being the key features of severe illness in extreme preterm infants.

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