Ultrasound and Functional Thyroid Evaluation

NCT ID: NCT04208503

Last Updated: 2021-08-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-12-19

Study Completion Date

2021-12-31

Brief Summary

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Thyroid disorders are most commonly concomitant with prematurity and still remains a controversial topic. The incidence of a temporary form of hypothyroidism among preterm neonates is higher than in the general population. Transient prematurity hypothyroxinemia is defined as a temporary reduction in FT4 values without increase in TSH values. Currently, there is no consensus about normal thyrotropine (TSH) and free thyroxine (FT4) values in preterm infants.

The aim of this study is to determine the volume of the thyroid gland in preterm infants born between 24 and 32 weeks of gestation inborn or admitted to the unit within 14 days from birth and compare it with the results of TSH and FT4 blood concentration. Besides, the objective of the study is to determine values of thyroid hormones in premature infants born before 33 wk gestation to help neonatologist to interpreter the thyroid hormone results

Detailed Description

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Thyroid disorders are most commonly concomitant with prematurity and still remains a controversial topic. Preterm infants are susceptible to thyroid disorders due to many reasons including immaturity of hypothalamopituitary-thyroid axis, non-thyroidal illness, impaired synthesis and metabolism of thyroid hormones, medication administration like dopamine, steroids, caffeine.The incidence of a temporary form of hypothyroidism among preterm neonates is higher than in the general population. Transient prematurity hypothyroxinemia is defined as a temporary reduction in FT4 values without increase in TSH values. It is a diagnostic challenge in order to differentiate it from thyroid disfunction in the critically ill patient. Currently, there is no consensus about normal thyrotropine (TSH) and free thyroxine (FT4) values in preterm infants. Given the delayed appearance of TSH value increase in preterm newborns additional thyroid evaluation methods are sought. We believe the thyroid ultrasound might prove helpful.

The aim of this study is to determine the volume of the thyroid gland in preterm infants born between 24 and 32 weeks of gestation inborn or admitted to the unit within 14 days from birth and compare it with the results of TSH and FT4 blood concentration. We will performed the thyroid ultrasound to estimate the thyroid volume to aid in the comparative evaluation of infants with suspected thyroid disease. The value of sonography thyroid volume will give specialists possibility to identify a gland as normal, small or enlarged. Besides, the objective of the study is to determine value of thyroid hormones in premature infants born before 33 wk gestation to help neonatologist to interpreter the thyroid hormone results

Conditions

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Thyroid Gland; Functional Disturbance

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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thyroid ultrasound

After meeting enrolment criteria the thyroid ultrasound will be performed at 32 and 36 weeks of gestation, blood test for TSH and FT4 will be obtained at 14-21 day of life, at 32 and 36 weeks of gestation

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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Diagnostic test blood test for TSH and FT4 concentration

Eligibility Criteria

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Inclusion Criteria

* preterm infants born between 24 and 32 weeks of gestation (estimated by ultrasound)
* in born or admitted to the unit within one week from birth
* randomization within 7 days from birth
* parental consent

Exclusion Criteria

* preterm delivery \<23 weeks of gestation or \> 32 weeks (estimated by ultrasound)
* major congenital abnormalities
* no parental consent
* medications used after birth: steroids, vasopressors (up to 12 hours after end of treatment)
* positive thyroid stimulating antibodies (TSAb) in the mother
* mothers with thyroid disease treated with antythyroid drugs
* mothers treated with amiodarone
Minimum Eligible Age

1 Week

Maximum Eligible Age

12 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Princess Anna Mazowiecka Hospital, Warsaw, Poland

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Aleksandra Mikolajczak, MD PhD

Role: STUDY_CHAIR

Princess Anna Mazowiecka

Locations

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Department of Neonatology and Neonatal Intensive Care Warsaw Medical University

Warsaw, , Poland

Site Status RECRUITING

Department of Neonatology and Neonatal Intensive Care Warsaw Medical University

Warsaw, , Poland

Site Status NOT_YET_RECRUITING

Countries

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Poland

Central Contacts

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Aleksandra Mikolajczak, MD PhD

Role: CONTACT

+48 603 440 112

Renata Bokiniec, Prof MD P

Role: CONTACT

+48 22 59 66 155

Facility Contacts

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Joanna Seliga-Siwecka, MD PhD

Role: primary

+48225966155

Joanna Seliga-Siwecka

Role: backup

References

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Chaudhari M, Slaughter JL. Thyroid Function in the Neonatal Intensive Care Unit. Clin Perinatol. 2018 Mar;45(1):19-30. doi: 10.1016/j.clp.2017.10.005. Epub 2017 Dec 13.

Reference Type BACKGROUND
PMID: 29406004 (View on PubMed)

McGrath N, Hawkes CP, Mayne P, Murphy NP. Optimal Timing of Repeat Newborn Screening for Congenital Hypothyroidism in Preterm Infants to Detect Delayed Thyroid-Stimulating Hormone Elevation. J Pediatr. 2019 Feb;205:77-82. doi: 10.1016/j.jpeds.2018.09.044. Epub 2018 Oct 24.

Reference Type BACKGROUND
PMID: 30529133 (View on PubMed)

Radetti G, Zavallone A, Gentili L, Beck-Peccoz P, Bona G. Foetal and neonatal thyroid disorders. Minerva Pediatr. 2002 Oct;54(5):383-400. English, Italian.

Reference Type BACKGROUND
PMID: 12244277 (View on PubMed)

Vigone MC, Caiulo S, Di Frenna M, Ghirardello S, Corbetta C, Mosca F, Weber G. Evolution of thyroid function in preterm infants detected by screening for congenital hypothyroidism. J Pediatr. 2014 Jun;164(6):1296-302. doi: 10.1016/j.jpeds.2013.12.048. Epub 2014 Feb 8.

Reference Type BACKGROUND
PMID: 24518164 (View on PubMed)

Khan SS, Hong-McAtee I, Kriss VM, Stevens S, Crawford T, Hanna M, Bada H, Desai N. Thyroid gland volumes in premature infants using serial ultrasounds. J Perinatol. 2018 Oct;38(10):1353-1358. doi: 10.1038/s41372-018-0149-0. Epub 2018 Jul 30.

Reference Type BACKGROUND
PMID: 30061589 (View on PubMed)

Oh KW, Koo MS, Park HW, Chung ML, Kim MH, Lim G. Establishing a reference range for triiodothyronine levels in preterm infants. Early Hum Dev. 2014 Oct;90(10):621-4. doi: 10.1016/j.earlhumdev.2014.07.012. Epub 2014 Aug 24.

Reference Type BACKGROUND
PMID: 25150803 (View on PubMed)

Kurtoglu S, Ozturk MA, Koklu E, Gunes T, Akcakus M, Yikilmaz A, Buyukkayhan D, Hatipoglu N. Thyroid volumes in newborns of different gestational ages: normative data. Arch Dis Child Fetal Neonatal Ed. 2008 Mar;93(2):F171. doi: 10.1136/adc.2007.130211. No abstract available.

Reference Type BACKGROUND
PMID: 18296580 (View on PubMed)

Goldis M, Waldman L, Marginean O, Rosenberg HK, Rapaport R. Thyroid Imaging in Infants. Endocrinol Metab Clin North Am. 2016 Jun;45(2):255-66. doi: 10.1016/j.ecl.2016.02.005.

Reference Type BACKGROUND
PMID: 27241963 (View on PubMed)

Knobel RB. Thyroid hormone levels in term and preterm neonates. Neonatal Netw. 2007 Jul-Aug;26(4):253-9. doi: 10.1891/0730-0832.26.4.253.

Reference Type BACKGROUND
PMID: 17710960 (View on PubMed)

Kaluarachchi DC, Colaizy TT, Pesce LM, Tansey M, Klein JM. Congenital hypothyroidism with delayed thyroid-stimulating hormone elevation in premature infants born at less than 30 weeks gestation. J Perinatol. 2017 Mar;37(3):277-282. doi: 10.1038/jp.2016.213. Epub 2016 Dec 1.

Reference Type BACKGROUND
PMID: 27906195 (View on PubMed)

Other Identifiers

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3/2019

Identifier Type: -

Identifier Source: org_study_id

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