Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul 18;14(7):e0220040.
doi: 10.1371/journal.pone.0220040. eCollection 2019.

Factors associated with moderate neonatal hyperthyrotropinemia

Ernesto Cortés-Castell  1 , Mercedes Juste  1 , Antonio Palazón-Bru  2 , Mercedes Goicoechea  3 , Vicente Francisco Gil-Guillén  2 , María Mercedes Rizo-Baeza  4
Affiliations

Factors associated with moderate neonatal hyperthyrotropinemia

Ernesto Cortés-Castell et al. PLoS One. .

Abstract

Background: Maternal iodine deficiency is related to high neonatal thyroid-stimulating hormone (TSH) values, with the threshold of 5 mIU/L recommended as an indicator of iodine nutrition status. The objective of this study was to analyse possible risk factors for increased TSH that could distort its validity as a marker of iodine status. The clinical relevance of this research question is that if the factors associated with iodine deficiency are known, iodine supplementation can be introduced in risk groups, both during pregnancy and in newborns.

Methods: A case-control study was carried out in a sample of 46,622 newborns in 2002-2015 in Spain. Of these, 45,326 had a neonatal TSH value ≥5 mIU/L. The main variable was having TSH ≥5 mIU/L and the secondary variables were: sex, gestational age, day of sample extraction and maternal origin. Associated factors were analysed through a logistic regression model, calculating the odds ratio (OR).

Results: The factors associated with this outcome were: male sex (OR = 1.34, 95% CI: 1.20-1.50, p<0.001), originating from an Asian/Oceanic country (OR = 0.80, 95% CI: 0.54-1.20, p = 0.536) or Europe (OR = 0.80, 95% CI: 0.66-0.96, p = 0.285) (including Spain, OR = 1) [p<0.001 for America (OR = 0.54, 95% CI: 0.44-0.68) and p = 0.025 for Africa (OR = 0.78, 95% CI: 0.62-0.97)] and fewer days from birth to sampling (OR = 0.80, 95% CI: 0.77-0.82, p<0.001).

Conclusions: The risk of high neonatal TSH without congenital hypothyroidism is higher in males, decreases with a greater number of days from birth to extraction, and is dependent on maternal ethnicity but not on gestational age.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

References

    1. Trumpff C, Vandevijvere S, Moreno-Reyes R, Vanderpas J, Tafforeau J, Van Oyen H, et al. Neonatal thyroid-stimulating hormone level is influenced by neonatal, maternal, and pregnancy factors. Nutr Res. 2015; 35: 975–981. 10.1016/j.nutres.2015.09.002 - DOI - PubMed
    1. Bosch-Giménez VM, Palazón-Bru A, Blasco-Barbero Á, Juste-Ruiz M, Rizo-Baeza MM, Cortés-Castell E. Multivariate Analysis of Thyrotropin in Preterm Newborns Based on Adequacy of Weight for Gestational Age. Thyroid. 2017; 27: 120–124. 10.1089/thy.2016.0338 - DOI - PubMed
    1. Lain SJ, Roberts CL, Wilcken B, Wiley V, Jack MM, Nassar N. Using record linkage to investigate perinatal factors and neonatal thyroid-stimulating hormone. J Paediatr Child Health. 2015; 51: 620–625. 10.1111/jpc.12783 - DOI - PubMed
    1. Ryckman KK, Spracklen CN, Dagle JM, Murray JC. Maternal factors and complications of preterm birth associated with neonatal thyroid stimulating hormone. J Pediatr Endocrinol Metab. 2014; 27: 929–938. 10.1515/jpem-2013-0366 - DOI - PMC - PubMed
    1. Ng SM, Wong SC, Paize F, Chakkarapani E, Newland P, Isherwood D, et al. Multivariate analyses of factors that affect neonatal screening thyroid stimulating hormone. J Pediatr Endocrinol Metab. 2011; 24: 727–732. - PubMed