Korean J Pediatr.  2014 Oct;57(10):425-433. 10.3345/kjp.2014.57.10.425.

Adrenal and thyroid function in the fetus and preterm infant

• Chung HR

• KMID: 2284381
• DOI: http://doi.org/10.3345/kjp.2014.57.10.425

Abstract

Adrenal and thyroid hormones are essential for the regulation of intrauterine homeostasis, and for the timely differentiation and maturation of fetal organs. These hormones play complex roles during fetal life, and are believed to underlie the cellular communication that coordinates maternal-fetal interactions. They serve to modulate the functional adaptation for extrauterine life during the perinatal period. The pathophysiology of systemic vasopressor-resistant hypotension is associated with low levels of circulating cortisol, a result of immaturity of hypothalamic-pituitary-adrenal axis in preterm infants under stress. Over the past few decades, studies in preterm infants have shown abnormal clinical findings that suggest adrenal or thyroid dysfunction, yet the criteria used to diagnose adrenal insufficiency in preterm infants continue to be arbitrary. In addition, although hypothyroidism is frequently observed in extremely low gestational age infants, the benefits of thyroid hormone replacement therapy remain controversial. Screening methods for congenital hypothyroidism or congenital adrenal hyperplasia in the preterm neonate are inconclusive. Thus, further understanding of fetal and perinatal adrenal and thyroid function will provide an insight into the management of adrenal and thyroid function in the preterm infant.

Keyword

Premature infant; Thyroid; Adrenal glands

MeSH Terms

Adrenal Glands
Adrenal Hyperplasia, Congenital
Adrenal Insufficiency
Axis, Cervical Vertebra
Congenital Hypothyroidism
Fetus*
Gestational Age
Homeostasis
Hormone Replacement Therapy
Humans
Hydrocortisone
Hypotension
Hypothyroidism
Infant
Infant, Newborn
Infant, Premature*
Mass Screening
Thyroid Gland*
Thyroid Hormones
Hydrocortisone
Thyroid Hormones