TY - JOUR
T1 - Postnatal administration of dexamethasone for weaning off the ventilator affects thyroid function
AU - Buimer, Maarten
AU - van Wassenaer, Aleid G.
AU - Kok, Joke H.
PY - 2008
Y1 - 2008
N2 - BACKGROUND: Very preterm neonates are at risk of hypothyroxinemia because of prematurity as well as because of neonatal disease. Hypothyroxinemia is associated with impaired developmental outcome. Preterm infants who cannot be weaned from the ventilator can be treated with dexamethasone. Glucocorticoid administration has been found to alter thyroid hormone parameters. Therefore, dexamethasone treatment in these infants might additionally impair their thyroid function, which could have consequences for developmental outcome. OBJECTIVE: To assess what changes in thyroid function occur in the first hours after initiating dexamethasone treatment in ventilated preterm infants. METHODS: Preterm infants, in whom the decision was taken to start dexamethasone treatment, were included. Thyroxine (T(4)), 3,5,3'-triiodothyronine (T(3)), reverse T(3) (rT(3)), thyroid-stimulating hormone (TSH) and cortisol were determined before and 6-9 h after administration of the first dose of a postnatal dexamethasone course. Details of clinical condition were recorded at both time points. RESULTS: Sixteen very preterm infants were included at a median age of 20 days. While clinical condition was stable between start of dexamethasone and 6-9 h thereafter, TSH and T(3) levels decreased significantly. rT(3) levels significantly increased, resulting in a decrease in the T(3)/rT(3) ratio. There was no statistically significant effect on the levels of T(4). CONCLUSION: Postnatal dexamethasone administration negatively affects thyroid functioning the preterm infant with severe chronic lung disease
AB - BACKGROUND: Very preterm neonates are at risk of hypothyroxinemia because of prematurity as well as because of neonatal disease. Hypothyroxinemia is associated with impaired developmental outcome. Preterm infants who cannot be weaned from the ventilator can be treated with dexamethasone. Glucocorticoid administration has been found to alter thyroid hormone parameters. Therefore, dexamethasone treatment in these infants might additionally impair their thyroid function, which could have consequences for developmental outcome. OBJECTIVE: To assess what changes in thyroid function occur in the first hours after initiating dexamethasone treatment in ventilated preterm infants. METHODS: Preterm infants, in whom the decision was taken to start dexamethasone treatment, were included. Thyroxine (T(4)), 3,5,3'-triiodothyronine (T(3)), reverse T(3) (rT(3)), thyroid-stimulating hormone (TSH) and cortisol were determined before and 6-9 h after administration of the first dose of a postnatal dexamethasone course. Details of clinical condition were recorded at both time points. RESULTS: Sixteen very preterm infants were included at a median age of 20 days. While clinical condition was stable between start of dexamethasone and 6-9 h thereafter, TSH and T(3) levels decreased significantly. rT(3) levels significantly increased, resulting in a decrease in the T(3)/rT(3) ratio. There was no statistically significant effect on the levels of T(4). CONCLUSION: Postnatal dexamethasone administration negatively affects thyroid functioning the preterm infant with severe chronic lung disease
U2 - https://doi.org/10.1159/000143395
DO - https://doi.org/10.1159/000143395
M3 - Article
C2 - 18612213
SN - 1661-7800
VL - 94
SP - 164
EP - 169
JO - Neonatology
JF - Neonatology
IS - 3
ER -