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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.
References
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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.
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.
Table 1.
Demographics and first thyroid function test in study population
Table 2.
Comparison of weight gain and feeding tolerance during the first 14 days of life between hypothyroidism group and control group
Table 3.
Comparison of thyroid function, weight gain and feeding tolerance between 2 weeks before and after L-thyroxine administration in hypothyroidism group (n=14)
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