Clinical characteristics and risk factors of thyroid dysfunction children in neonatal intensive care unit
Objective To analyze the risk factors and clinical characteristics of thyroid dysfunction oc-curring in neonatal intensive care unit(NICU).Methods Neonates admitted to the NICU of Xuzhou Chil-dren's Hospital from January 2021 to December 2022 were selected as the study subjects,and were divided into the thyroid dysfunction group and the normal thyroid function group according to the results of the thyroid test.Epidemiological characteristics and relevant clinical data of the neonates were collected,and the risk factors for thyroid dysfunction were analyzed by single factor and multifactorial Logistic regression.They were divided into four subgroups according to gestational age,and the incidence rates and clinical characteristics of thyroid dysfunction in different gestational age groups were compared.Results A total of 2 716 cases were included.The results of univariate analysis showed that the thyroid dysfunction group had statistically significant differ-ences in birth weight,gestational age,Apgar score,maternal age,mode of delivery,history of multiple pregnan-cies,neonatal respiratory distress syndrome,gestational hypertension,gestational thyroid dysfunction,use of al-veolar surfactant,and use of dopamine/dobutamine compared with the normal thyroid function group(P＜0.05);multiple factor Logistic regression analysis showed that small gestational age(＜32 W,OR=2.287,P＜0.01;～34W,OR=7.808,P＜0.01;～＜37 W,OR=3.314,P＜0.01),low birth weight(＜1 500 g,OR=1.555,P=0.027),low Apgar score(0～3 points,OR=4.689,P＜0.01;4～7 points,OR=1.679,P=0.002),and thyroid dys-function during pregnancy(OR=3.044,P＜0.01)were independent risk factors for neonatal thyroid dysfunction.The overall incidence of neonatal thyroid dysfunction in the NICU was 20.54％(558/2 716);congenital hypo-thyroidism was 0.48％(13/2 716),transient hypothyroidism was 1.40％(38/2 716),transient hypothyroxemia was 2.61％(71/2 716),low T3 syndrome was 2.69％(73/2 716),and hyperthyrotropinemia was 13.37％(363/2 716).There is a statistically significant difference in the incidence of transient hypothyroidism and transient hypothy-roxinemia in different gestational age groups(P＜0.05).Premature infants in the thyroid dysfunction group had a longer time to achieve full enteral feeding than those in the normal thyroid function group[gestational age＜32 W group:13(12,15)d vs 13(10,14)d,Z=-2.193,P＜0.05;～34 W group:8(6,9)d vs 7(5,7)d,Z=-2.178,P＜0.05].Conclusion Different types of thyroid dysfunction can occur in newborns in the NICU.There are many risk factors,and the characteristics of thyroid dysfunction occurring in different gestational age groups are dif-ferent.Therefore,for newborns in the NICU with risk factors,thyroid function should be tested in a timely man-ner,and timely intervention should be carried out.The overall prognosis is good.
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