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Thyroid HT did not improve neurodevelopment in premature infants
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In infants born before 28 weeks of gestational age, neonatal thyroid hormone treatment did not appear to have an effect on neurodevelopment, according to study findings published in Thyroid.
In the multicenter, phase 1 clinical trial, researchers evaluated the effects of four different regimens of thyroid HT in 166 infants born between 24 and less than 28 weeks gestational age and enrolled within 24 hours of birth. The four regimens consisted of differing doses and delivery methods, including bolus or continuous infusion. There were eight treatment arms: six treatment arms that underwent therapy with various doses of thyroid hormone (4, 8 and 16 mcg/kg/day thyroxine, bolus or continuous), one treated with iodine only and one placebo group that received dextrose.
At age 3 years, the children were evaluated for various parameters of neurodevelopment, including developmental index scores, motor skills, rates of cerebral palsy and rates of death or severe developmental delay. These factors were compared between the eight groups and between different dosage levels. The researchers also evaluated these factors in relation to whether the infants had received thyroid HT or placebo.
Of the 166 infants who were initially randomly assigned, 32 died as neonates. Within 134 survivors, there was accessible follow-up data for 89 children (66%).
Statistical analysis demonstrated that there were no significant differences in development rates of cerebral palsy based on any of the thyroid HT variables.
According to the researchers, these findings were limited by the high attrition rate, which left follow-up data for only 66% of the original infants. They wrote that, overall, the study participants at age 3 years did not demonstrate poor neurodevelopment.
“In general, the neurodevelopmental outcome of the 89 infants in our study was good, with only 9% having cerebral palsy, and only 2% severe forms of [cerebral palsy]," the researchers wrote. "This is consistent with outcome data reported in other international cohorts of infants born after a similar gestational age, without T4 supplementation.”
Disclosure: The researchers report no relevant financial disclosures.
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