Infant, Newborn Clinical Trial
Official title:
Thyroid Function in Term and Near Term Infants With Respiratory Distress and Its' Relation to Severity of Illness
This study was designed to evaluate the level of certain hormones (thyroid hormones and
cortisol) in full term or close to full term infants who have respiratory distress severe
enough to require respiratory support. The purpose of this study is to determine if there is
a relationship between these hormone levels and how sick these infants are who require help
with breathing following birth.
Hypothesis: Infants who are born full term or near full term and who have low hormone levels
will have higher severity of illness.
Transient hypothyroxinemia, as demonstrated by low T4 and free T4 levels with normal levels
of TSH, in preterm infants has been associated with increased severity of illness and
adverse outcomes. Effects of thyroid function in term infants is less well studied. Previous
research in the Special Care Nursery at Christiana Hospital has indicated that transient
hypothyroxinemia in intubated term infants was associated with increased severity of illness
and the need for more intensive rescue therapies. However, free T4, the biologically active
substance was not measured in our previous study.
Infants who meet criteria for the study will begin participation after parental informed
consent is obtained. Infants who are enrolled will have serial measurements of thyroid
stimulating hormone (TSH), T4, free T4, free T3, and cortisol. These measurements will be
obtained at four specific time intervals throughout the first week of the infant's life. The
medical team will be blinded to the results of the hormone testing. The results will be
reviewed by an unblinded study investigator and an endocrinologist will be consulted if
abnormal results are reported.
These hormone levels will be compared with severity of illness and level of respiratory
support needed in order to establish an association between thyroid function and illness
severity. Illness severity will be quantified by using the Score for Neonatal Acute
Physiology (SNAP). SNAP scores require collecting data from vital signs and results of labs
that are considered standard of care.
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