Nowadays, taking care of preterm birth is associated with an important increase in survival. This increased survival comes with impairment in neurodevelopmental outcomes in long term evaluation. Thyroid hormones are essentials for brain development, especially for neuronal differentiation. Transient hypothyroxinaemia of prematurity (THOP) is a frequent condition defined by decreased thyroid hormones without the expected rise in thyroid stimulating hormone. Various studies have showed various results regarding the consequences of THOP on neurodevelopment in premature neonates. However, the biggest and most powerful studies agree to say that THOP impair neurodevelopment. On the other hand, only a few studies evaluated the impact of treatment of THOP, and only two focused on treating exclusively the neonates with a biological diagnosis of THOP (Suzumura and co. in 2010 and Nomura and co. in 2014) and their results are inconsistent. In this study, we aim to show that a treatment with L-thyroxine at a dose of 7.5 µg/kg/j for neonates diagnosed with THOP (defined as a level of l-T4 \< 12 pmol/L and a level of TSH \< 15 mUI/L before 15 days of life or \< 85 mUI/L after 15 days of birth) is associated with an increased neurodevelopmental prognosis.
Study Type
OBSERVATIONAL
Enrollment
373
Subjects diagnosed with THOP (as previously defined) and treated with L-thyroxine at a dose of 7.5 µg/kg/d are less likely to have an impaired ASQ score at 4 years of corrected age.
Subjects diagnosed with THOP (as previously defined) and who received no L-thyroxine treatment.
Subjects diagnosed no-THOP (as previously defined)
HFME
Bron, France
CHU Grenoble
Grenoble, France
CHU Saint EtienneHopital
Saint-Etienne, France
Neuro-development judged " abnormal " by the paediatrician during the two years of corrected age's consultation.
Neuro-development is evaluated routinely by paediatricians during consultation, and this evaluation is reported in medical files.
Time frame: Evaluation at two years of corrected age.
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