Pelin DOĞAN, Erdal EREN, Halil SAĞLAM, Nilgün KÖKSAL, İpek GÜNEY VARAL, Cansu CANBOLAT, Onur BAĞCI, Hilal ÖZKAN

Prematüre Bebeklerde Tiroid Fonksiyon Testlerinin Sonuçları

Giriş: Prematüre bebeklerde tiroid fonksiyon testlerindeki (TFT) bozukluğun sıklığı, etiyolojisi ve morbiditelerle ilişkisinin belirlenmesi.Gereç ve Yöntem: Bu çalışmaya Ocak 2009 ve Ocak 2012 yılları arasında Uludağ Üniversitesi yenidoğan yoğun bakım ünitesinde yatarak tedavi görmüş olan toplam 139 prematüre bebek alındı. Hastaların prenatal, natal ve postnatal özellikleri ve alınmış olan TFT değerleri kaydedildi. Tüm hastaların yaşamın 1. ve 3. haftasında TFT çalışıldı. Tiroid stimülan hormon (TSH) düzeyi 10 IU/L üzerindeki değerler yüksek kabul edildi. Serbest T3 ve T4 değerleri laboratuvar sınırları göz önüne alınarak değerlendirildi. Hipotiroidi tanısı olan ve olmayan tüm hastaların poliklinik izlemlerinden 6, 12 ve 18. aylardaki tartı, boy ve baş çevresi ölçümleri değerlendirmeleri kaydedildi.Bulgular: Çalışmamızda 41 hastanın (%24) TFT'sinde anormallik tespit edilmiş olup olguların 22'sinde (%53,6) geçici TSH yüksekliği, 9'unda (%22) primer hipotiroidi, 9'unda (%22) nontiroidal hastalık ve 1'inde (%2,4) geçici hipotiroksinemi izlendi. Tiroid fonksiyon bozukluğu olan hastalarda respiratuvar distres sendromu sıklığı anlamlı derecede yüksek saptandı (p=0,007). Annesinde hipotiroidi olan bebeklerde tiroid fonksiyon bozukluğu oranı maternal hipotiroidi olmayan bebeklere göre anlamlı derecede yüksek saptandı (p=0,049). TFT'de bozukluk olan grupta 18. aydaki baş çevresi ortalaması TFT normal gruba kıyasla anlamlı olarak düşüktü (p=0,047).Sonuç: Prematürelerde tiroid fonksiyon bozukluğu sık görülen bir morbiditedir ve nöromotor gelişim açısından önemlidir. Maternal tiroid fonksiyon bozukluğu bebeklerde tiroid testlerinde bozulmaya yol açabilir. Tüm prematüre bebeklerde TFT'lerinde çalışılmalı ve hipotiroidi tedavi edilmelidir. Prematürelerde iyot maruziyetinin azaltılması TFT bozukluğu ve geçici hipotiroidi oranını azaltabilir

Results of Thyroid Function Tests in Premature Infants

Introduction: To determine the rate, etiology and morbidity association of disorders of thyroid function tests (TFTs) in premature babies.Materials and Methods: A total of 139 premature babies who were admitted to Uludag University Faculty of Medicine Hospital Neonatal Intensive Care Unit between January 2009 and January 2012 were included in this study. Prenatal, natal and postnatal characteristics along with TFTs results were recorded. TFTs were performed for all patients in the first and third weeks of life. Thyroid stimulation hormone (TSH) values of >10 IU/L was considered elevated. Free T3 and T4 levels were evaluated according to laboratory cut-off values. Weight, height and head circumference values of all individuals with and without the diagnosis of hypothyroidism on the 6th, 12th, and 18th months of their polyclinic follow-ups Results: Abnormal TFTs were detected in 41 (24%) patients. Twenty two patients (53%) had transient TSH elevation, 9 (22%) had primary hypothyroidism, 9 (22%) had non-thyroidal disease and 1 (2.4%) had transient hypothyroxinemia. Among morbidities, respiratory distress syndrome rate was found to be significantly higher in patients with thyroid function disorders (p=0.007). The rate of thyroid function disorders in patients with mothers with hypothyroidism was significantly more frequent compared to patients without maternal hypothyroidism (p=0.049). The mean head circumference in 18 month was significantly lower in patients with abnormal TFTs (p=0.047). Conclusions: Thyroid function disorders are common morbidities in premature babies and are important for neuromotor development. Maternal thyroid function disorder can lead to impairment of TFTs in infants. Thyroid function tests should be performed in all premature babies and hypotyhroidism should be treated. Avoidance of iodine exposure in premature infants can reduce the rate of abnormal TFTs and transient hypothyroidism

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