Abstract

Objective Low triiodothyronine syndrome (LT3S) is a common endocrine disease in preterm neonates. Various serious acute or chronic diseases result in LT3S. Few studies have investigated the causal relationship between perinatal factors and LT3S in preterm neonates with a gestational age (GA) of 28–35 weeks. The present study comprehensively analyzed the perinatal factors of LT3S in preterm neonates. Methods This was a retrospective study of neonates with and without LT3S from January 2018 to November 2019. Compared to 206 preterm neonates without LT3S, 158 neonates were diagnosed with LT3S, excluding neonates with congenital malformations, other endocrine diseases, genetic diseases and inherited metabolic diseases. Results Five perinatal risk factors for LT3S were confirmed using univariate and multivariate analyses: smaller gestational age, lower birth weight, respiratory distress syndrome (RDS), neonatal sepsis, and dopamine use. Conclusions LT3S in preterm neonates was associated with multiple perinatal factors, including smaller gestational age, lower birth weight, RDS, sepsis, and dopamine use. Preterm neonates with a GA of 28–35 weeks who are exposed to a series of high-risk perinatal factors must be closely observed, diagnosed early and treated for primary diseases promptly to reduce the occurrence of LT3S and improve the outcomes. Key Message: Few studies have investigated the relationship between perinatal factors and Low triiodothyronine syndrome (LT3S) in preterm neonates with a gestational age (GA) of 28-35 weeks. LT3S was associated with multiple perinatal factors, including smaller gestational age, lower birth weight, respiratory distress syndrome (RDS), sepsis, and dopamine use.

Highlights

  • Low triiodothyronine syndrome (LT3S) is a common endocrine disease in preterm neonates

  • Analyses of maternal factors revealed that Gestational diabetes mellitus (GDM), hypertension in pregnancy, anaemia in pregnancy, and thyroid diseases were not related with LT3S in neonates (p > .05)

  • We found a relationship between LT3S in preterm neonates with a gestational age (GA) of 28–35 weeks and multiple perinatal factors, including factors involving the mother, neonatal neonates and drugs

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Summary

Introduction

Low triiodothyronine syndrome (LT3S) is a common endocrine disease in preterm neonates. Reichlin [1] first discovered LT3S in the serum of patients with advanced non-thyroid diseases. It is become increasingly important to trace the perinatal factors of LT3S in preterm neonates. Serum FT3 and FT4 between 72 and 96 h after birth predicted the degree of asphyxia-induced brain damage in neonates [6]. A prospective experimental study confirmed that preterm neonates with respiratory distress syndrome (RDS) showed decreased T3 values on the fifth day after birth but no significant change in thyroid-stimulating hormone (TSH) values [3]. The relationship between perinatal factors, such as neonatal sepsis and prenatal dexamethasone (DXM) use, and LT3S in preterm neonates was discussed in some articles [7,8]

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