Thyroid Function in the Neonatal Intensive Care Unit

Abstract

Patients in the neonatal intensive care unit (NICU) are at high risk for abnormal thyroid function testing because of illness and preterm birth. Preterm infants are born before hypothalamic-pituitary-thyroid axis maturation and the normal feedback mechanisms that regulate thyroid hormone production remain immature. Preterm and sick infants may develop hypothyroidism even if routine thyroid screening tests collected in the first several days after birth are normal. This article reviews normal hypothalamic-pituitary-thyroid axis maturation, thyroid hormone testing and interpretation in the NICU, and the current evidence for and against levothyroxine treatment of NICU patients with borderline abnormal thyroid function testing.

Keywords: Congenital hypothyroidism; Neonatal intensive care unit; Preterm infants; Thyroid function testing; Thyroid screening; Thyroid testing artifacts.