Table of Contents

HK J Paediatr (New Series)
Vol 7. No. 1, 2002

HK J Paediatr (New Series) 2002;7:25-32

Original Article

The Hypothyroxinaemia of Prematurity

LY Siu, NS Kwong


Transient hypothyroxinaemia of prematurity (THOP) is common. The preponderance of evidence indicates that at the very least THOP is a marker of elevated risk of neurodevelopmental adversity. Existing observational and experimental studies could neither support nor dispute the use of thyroid hormones in preterm infants. The experimental studies39-42 done so far had major limitations because of the small number of infants enrolled in the trials. For future large multicenter randomized trials, energies should be focused on assessing neurodevelopment objectively in survivors and consider enrolling only those infants most likely to benefit from thyroid hormones replacement therapy. Moreover, the addition of triiodothyronine (T3) to the treatment schedule needs to be seriously considered. Furthermore, since local pilot study revealed iodine deficiency in 35.8% of the studied healthy pregnant women3 and the effect of iodine deficiency may probably be more significant in preterms, one will probably choose to treat.

早產兒一過性低甲狀腺素血症(THOP)是比較常見的。大量研究表明即使是最輕微的 THOP 也可能增加神經系統發育不良的風險。關於應用甲狀腺素治療早產兒,現有的觀察性和實驗性研究都無法證實或提出異議。由於註冊參加臨床試驗的嬰兒數量太少,所以迄今為止已報道的實驗性研究都存在較大的局限。為了開展大規模的多中心隨機試驗,必須關注如何客觀評價存活患兒的神經發育情況,還必須切記參加註冊的僅是那些得益於甲狀腺素替代療法的患兒,此外療程中是否加用三碘甲狀腺氨酸(T3)也須慎重考慮。而且,局部的預試驗顯示 35.8% 的健康孕婦患有碘缺乏,而碘缺乏對早產兒的影響可能更大,所以二者其一需要接受治療。

Keyword : Hypothyroidism; Hypothyroxinaemia; Prematurity



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