Congenital Hypothyroidism with a Delayed Thyroid-Stimulating Hormone Elevation in Very Premature Infants: Incidence and Growth and Developmental Outcomes

Objective To test the hypothesis that very low birth weight (VLBW) and extremely low birth weight (ELBW) infants have an increased incidence of congenital hypothyroidism (CH) with a delayed thyroid-stimulating hormone (TSH) elevation and that the outcomes of these infants are similar to control infants. Study design Retrospective analysis of newborn thyroid screening data for 92 800 live births in Rhode Island to identify CH with a delayed TSH elevation. Developmental, growth, and endocrine outcomes of the index cases were assessed at 18 months corrected age. Results CH with a delayed TSH elevation occurred in 1 in 58 ELBW, 1 in 95 VLBW, and 1 in 30 329 infants weighing >= 1500 grams (P < .0001). The incidence of head circumference < 10(th) percentile was higher in VLBW infants with CH associated with a delayed TSH elevation (P < .05), and the mean head circumferences, weights, lengths, and developmental scores were similar to matched control infants. Three infants received short-term levothyroxine replacement. Conclusions The incidence of CH with a delayed TSH elevation was higher in ELBW and VLBW infants compared with infants weighing >= 1500 grams. The outcomes of these infants were comparable with matched control infants. (J Pediatr 2011; 158:538-42).