Abstract
Thyroid hormone signaling is required for both fetal and pediatric development. Hypothyroidism and hyperthyroidism may present in the neonatal period. Hypothyroidism is more common, and the goal of thyroid hormone replacement in neonates is to optimize normal growth and development. In neonates with hyperthyroidism, there is a risk of acute morbidity and mortality and some evidence to suggest the potential for long-term adverse neurocognitive outcomes. This chapter reviews the etiology for both thyroid states (including genetic and clinical risk factors, thyroid hormone metabolism, transport, and receptor function) and the evaluation and treatment of neonatal thyroid disorders. Further clinical research is needed to understand the consequences of fetal and neonatal hypothyroxinemia as well as thyrotoxicosis, especially for preterm and/or critically ill infants, to better understand the potential benefits and risks of treatment.
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