Ten-year follow-up of children born at <30 weeks' gestational age supplemented with thyroxine in the neonatal period in a randomized, controlled trial.
BACKGROUND
Thyroid hormones are essential for brain development. We conducted a randomized, controlled trial with thyroxine (T4) supplementation in infants <30 weeks' gestation and with the last neurodevelopmental follow-up moment at the age of 5.5 years. T4 supplementation was associated with improved outcome of infants <28 weeks' gestation and worse outcome of infants of 29 weeks' gestation. We studied gestational age-dependent effects of T4 supplementation at the mean age of 10.5 years in children participating in our randomized, controlled trial.


METHODS
Questionnaires regarding school outcome, behavior, quality of life, motor problems, and parental stress were sent to the parents and children and their teachers at the same time point for all surviving children (9-12 years of age).


RESULTS
Seventy-two percent of the families responded to our questionnaires. Nonrespondents had more sociodemographic risk factors and worse development until 5.5 years. At the mean age of 10.5 years, T4 supplementation was associated with better school outcome in those who were <27 weeks' gestation and better motor outcome in those who were <28 weeks' gestation, whereas the reverse was true for those who were born at 29 weeks' gestation. No other gestational age-dependent outcomes were found.


CONCLUSIONS
Gestation-dependent effects of T4 supplementation remain stable over time. These effects do not prove beneficial effects of T4 in infants <28 weeks but should be the background for a new randomized, controlled trial with thyroid hormone in this age group.
van Wassenaer
Aleid G
AG
Department of Neonatology, Emma Children's Hospital Academic Medical Center, Amsterdam, The Netherlands. a.vanwassenaer@amc.uva.nl
Westera
Jolanda
J
Houtzager
Bregje A
BA
Kok
Joke H
JH
D001921:Brain / Q000254:growth & development; D002648:Child; D002652:Child Behavior; D002657:Child Development; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis / Q000517:prevention & control; D004311:Double-Blind Method; D004519:Education, Special; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007360:Intelligence; D011597:Psychomotor Performance; D011788:Quality of Life; D013974:Thyroxine / Q000097:blood / Q000502:physiology / Q000627:therapeutic use*
D013974:Thyroxine