title: Effects of thyroxine supplementation on neurologic development in infants born at less than 30 weeks' gestation.
abstract: BACKGROUND
  Premature infants who have transient hypothyroxinemia in the first weeks of life may have developmental delay and neurologic dysfunction. Whether thyroxine treatment during this period results in improved developmental outcomes is not known.
  
  
  METHODS
  We carried out a randomized, placebo-controlled, double-blind trial of thyroxine supplementation in 200 infants born at less than 30 weeks' gestation. Thyroxine (8 microg per kilogram of birth weight) or placebo was administered daily, starting 12 to 24 hours after birth, for six weeks. Plasma free thyroxine concentrations were measured weekly for the first eight weeks after birth. Scores on the Bayley Mental and Psychomotor Development Indexes and neurologic function were assessed at 6, 12, and 24 months of age (corrected for prematurity).
  
  
  RESULTS
  Mortality and morbidity up to the time of discharge from the hospital were similar in the study groups. At 24 months of age, 157 infants were evaluated. Overall, neither mental nor psychomotor scores differed significantly between the study groups at any time, nor was the frequency of abnormal neurologic outcome significantly different. In thyroxine-treated infants born at gestational ages of less than 27 weeks, the score on the Bayley Mental Development Index at 24 months of age was 18 points higher than the score for the infants with similar gestational ages at birth in the placebo group (P=0.01); for thyroxine-treated infants born at 27 weeks or later, the mental-development score was 10 points lower than that of their counterparts in the placebo group (P=0.03). There was no relation between the initial plasma free thyroxine concentration and the effect of treatment.
  
  
  CONCLUSIONS
  In infants born before 30 weeks' gestation, thyroxine supplementation does not improve the developmental outcome at 24 months.
authors.affiliation: Department of Neonatology, Academic Medical Center, University of Amsterdam, the Netherlands.
authors.forename: A G
authors.initials: AG
authors.lastname: van Wassenaer
authors.forename: J H
authors.initials: JH
authors.lastname: Kok
authors.forename: J J
authors.initials: JJ
authors.lastname: de Vijlder
authors.forename: J M
authors.initials: JM
authors.lastname: Briët
authors.forename: B J
authors.initials: BJ
authors.lastname: Smit
authors.forename: P
authors.initials: P
authors.lastname: Tamminga
authors.forename: A
authors.initials: A
authors.lastname: van Baar
authors.forename: F W
authors.initials: FW
authors.lastname: Dekker
authors.forename: T
authors.initials: T
authors.lastname: Vulsma
mesh_terms: D002490:Central Nervous System / Q000187:drug effects; D002657:Child Development / Q000187:drug effects*; D002658:Developmental Disabilities / Q000517:prevention & control; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood; D008297:Male; D009483:Neuropsychological Tests; D011597:Psychomotor Performance / Q000187:drug effects; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use*
chemical_list: D013974:Thyroxine