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Endocrine Care: Fiona L. R. Williams, Gary J. Mires, Carol Barnett, Simon A. Ogston, Hans van Toor, Theo J. Visser, Robert Hume with collaboration from the Scottish Preterm Thyroid Group Transient Hypothyroxinemia in Preterm Infants: The Role of Cord Sera Thyroid Hormone Levels Adjusted for Prenatal and Intrapartum Factors J Clin Endocrinol Metab 2005; 90: 4599-4606 [Abstract] [Full text] [PDF]

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Perinatal Factors and Transient Hypothyroxinemia of Prematurity

Giuseppe Latini, Claudio De Felice, Paolo Toti, Grazia Ladisa   (29 September 2005)

Perinatal Factors and Transient Hypothyroxinemia of Prematurity 29 September 2005
Giuseppe Latini, MD 4Clinical Physiology Institute, National Research Council of Italy (IFC-CNR), Lecce Section, Italy, Claudio De Felice, Paolo Toti, Grazia Ladisa Send letter to journal: Re: Perinatal Factors and Transient Hypothyroxinemia of Prematurity gilatini{at}tin.it Giuseppe Latini, et al.	Dear Sir, We read with great interest the paper by Williams et al. (1), regarding the role of prenatal and gestational factors on the transient hypothyroxinemia of prematurity (THOP). However, among the several perinatal factors possibly related to T4 levels on day 7, histological chorioamnionitis (HCA) was not included, even though it is one of the more important risk factors for higher neonatal illness severity scores in very low birth weight (VLBW) premature infants (2-4). Recently, we have documented an inverse relationship between whole blood T4 concentrations on day 4 and HCA in a cohort of premature VLBW infants (5), pointing out the possible role of a fetal systemic inflammatory response syndrome among the pathogenetic factors of THOP. The T4 cut-off threshold found to best discriminate between HCA-positive and HCA-negative VLBW infants was significantly lower than the one commonly used in our congenital hypothyroidism diagnostic strategy. If the reported association findings are confirmed, HCA has to be included among the perinatal factors for selection of extremely preterm infants into clinical trials of T4 supplementation. REFERENCES 1. Williams FL, Mires GJ, Barnett C, Ogston SA, van Toor H, Visser TJ, Hume R, Scottish Preterm Thyroid Group 2005 Transient hypothyroxinemia in preterm infants: the role of cord sera thyroid hormone levels adjusted for prenatal and intrapartum factors. J Clin Endocrinol Metab. 90:4599-606. 2. De Felice C, Latini G, Del Vecchio A, Toti P, Bagnoli F, Petraglia F 2002 Small thymus at birth: a predictive radiographic sign of bronchopulmonary displasia. Pediatrics 110:386-388. 3. De Felice C, Vacca P, Presta G, Rosati E, Latini G 2003 Small thymus size at birth and neonatal outcome in very-low-birth-weight infants Eur J Pediatr 162:204–206. 4. De Felice C, Toti P, Parrini S, Del Vecchio A, Bagnoli F, Latini G 2005 Histologic Chorioamnionitis and Initial Severity of Illness in Very Low Birth Weight Newborns. Pediatr Crit Care Med 6:298-302 5. De Felice C, Bagnoli F, Toti P, Musaṛ MA, Peruzzi L, Paffetti P, Latini G. Histologic Chorioamnionitis and Transient Hypothyroxinemia of Prematurity. J Perinat Med (in press).