Korean J Perinatol.  2015 Mar;26(1):46-52. 10.14734/kjp.2015.26.1.46.

Comparison of Enteral Feeding in Early Neonatal Period in Very Low Birthweight Infants with Hypothyroidism

• Choi EK
• Lee HS
• Lee EH
• Kim SY
• Lee BK
• Jung YH
• Heo JS
• Shin SH
• Kim EK
• Kim HS
• Choi JH

• KMID: 2072336
• DOI: http://doi.org/10.14734/kjp.2015.26.1.46

Abstract

PURPOSE
We investigated the effects of hypothyroidism on feeding advancement in very low birth weight infants (VLBW).
METHODS
This study was a retrospective case-control study of 14 very low birth weight infants (VLBWIs) diagnosed with hypothyroidism and other 14 infants were recruited as age- and weight-matched controls without hypothyroidism or hypothyroxinemia in Seoul National University Children's Hospital between January 2007 and August 2009. We examined whether these infants gained weight more, achieved full-volume enteral feedings sooner, had fewer episodes of increased pre-gavage residuals, and had fewer days of parenteral nutrition.
RESULTS
Until full enteral feeding (120 mL/kg/day) was not statistically significant between the groups. In the hypothyroidism group, during the first 14 days after birth, the volume of feeding was smaller [14.7 (0.5-84.0) mL/kg/day, P=0.041], the episodes of increased pre-gavage residuals were frequently observed [16.7 (0.2-78) times, P=0.036], and the duration of central line was significantly longer [18 (10-50) days, P=0.018]. In hypothyroidism group, mean day at first L-thyroxine supplementation was 24.2+/-10.2 days after birth. L-thyroxine administration boosted thyroid function for hypothyroidism infants, helped them tolerate a larger amount of enteral feeding [from 89.5 (2.9-160.8) to 146.9 (31.8-178.8) mL/kg/day, P=0.002] and decreased episodes of excessive gastric residuals [from 5.5 (0-41.6) to 0 (0-44) time, P=0.026]. However, no more weight gain was statistically found.
CONCLUSION
In VLBW infants, hypothyroidism may induce feeding intolerance. L-thyroxine supplementation was effective in feeding advancement on preterm infants with hypothyroidism.

Keyword

Very low birth weight infant; Premature infant; Hypothyroidism; Enteral feeding

MeSH Terms

Case-Control Studies
Enteral Nutrition*
Humans
Hypothyroidism*
Infant*
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Parenteral Nutrition
Parturition
Retrospective Studies
Seoul
Thyroid Gland
Thyroxine
Weight Gain
Thyroxine

Figure

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  Fig. 1. Comparison of feeding volumes (A) and episodes of residues per day during 14 days after birth (B) between the hypothyroidism group and control group.

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  Fig. 2. In hypothyroidism infants, comparison of episodes of gastric residues per day between 2 weeks before and after L-thyroxine administration, respectively. They showed fewer episodes of residue per day after L-thyroxine administration (P=0.01). In control group, “day 0” means the 24 days after birth which is the mean day of L-thyroxine administration for hypothyroidism infants.

Reference

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