Patterns of Endocrine Disorders in a Neonatal Intensive Care Unit: A Single-Center Retrospective and Descriptive Study

Abstract

Background: Endocrine disorders in infants in neonatal intensive care units (NICU) represent a significant clinical concern. Understanding the frequency and variety of these disorders is crucial for effective patient management. Objectives: This single-center retrospective study was conducted to examine the frequency and patterns of endocrine disorders among neonates in the NICU. Methods: We performed a retrospective review of 1 845 patient records over five years from the NICU at Çanakkale Onsekiz Mart University Health Practice and Research Hospital. The study included patients admitted between January 1, 2016, and March 31, 2021, who were diagnosed with endocrine disorders according to the international classification of diseases (ICD). Diagnostic criteria were used to identify and categorize endocrine disorders, primarily focusing on hypoglycemia, congenital hypothyroidism, hypothyroxinemia of prematurity, neonatal hyperthyrotropinemia (HTT), and disorders of calcium and magnesium metabolism. Data analysis was conducted using descriptive statistics. Results: Endocrine disorders were identified in 14.6% (CI: 13.15 - 16.38) of the neonates. The most prevalent were thyroid disorders (5.15%, CI: 4.23 - 6.25), disorders of calcium metabolism (3.68%, CI: 2.92 - 4.64), and disorders of glucose homeostasis (3.63%, CI: 2.87 - 4.58). Notably, neonatal HTT was more frequent than previously reported. The majority of endocrine issues occurred in premature infants. Hypoglycemia was the most frequent glucose homeostasis disorder, affecting 24.7% (CI: 19.9 - 30.2) of those diagnosed with endocrine issues. Among the cases with calcium metabolism disorders, hypocalcemia was predominant (79.4%, CI: 68.3 - 87.3), with the majority (89%, CI: 80.1 - 95.9) being classified as early neonatal hypocalcemia. Conclusions: Endocrine disorders, particularly those related to thyroid, calcium, and glucose homeostasis, remain prevalent issues in the NICU. Prematurity significantly contributes to these complications. The frequency and variety of endocrine disorders are likely to evolve with improvements in laboratory techniques and diagnostic methods. Future larger-scale studies could provide more comprehensive insights into these disorders.