Абстрактный

Role of low dose thyroxine for subclinical hypothyroidism in preterm babies less than 34 weeks with feed intolerance.

Balakrishnan G, Kumar N*

Background: Feeding intolerance in premature infants is one of the main causes of prolonged hospital stay. Thyroxine and motilin plays significant role in GI function. In this study, we evaluated the effectiveness of low dose thyroxine in feeding intolerance of preterm neonates.

Objective: To find out low dose thyroxine therapy in preterm infants ≤ 34 weeks with feed intolerance improve gastro oesophageal reflux, gastric emptying and reduces the feed intolerance, that will be reflected in decreased duration of hospital stay and improved weight gain.

Study design: Parallel cross over study.

Participants: Preterm newborns ≤ 34 weeks with feed intolerance in SNCU of Coimbatore medical college hospital from 1st April 2021 to 30th October 2021.

Intervention: Group 1 received low dose thyroxine 5 microgram/kg along with the other treatment protocol followed while the group 2 was continued with the standard treatment protocol alone. After one week of treatment, the preterm that was not given thyroxine at the beginning were given low dose thyroxine (if symptoms persist) and the effect on feeding intolerance symptoms watched.

Outcome and results: Time to achieve full feeds (140-150 ml/kg/day), weight gain per grams per day (20-30 grams/kg/day) were end point goals. Total preterm <34 weeks babies admitted were 474. Only 30 babies had feeding intolerance (incidence 6.5%). 15 babies in group 1 received low dose thyroxine on D1. Other group received on D8. There is statistically significant difference between both groups at both pre intervention and post intervention period in milk intake and weight at all times expect for weight difference on day 7.

Conclusion: Thyroxine supplementation is effective in improving the symptoms of abdominal distension and poor weight gain in preterm infants and therefore aid in neurodevelopmental outcome in premature infants.