L-Thyroxine Supplementation for Preterm Newborns Less Than 32 Weeks of Gestation With Transient Hypothyroxinemia of Prematurity: a Prospective Randomized Double-blind Trial
Overview
- Phase
- Phase 3
- Intervention
- water
- Conditions
- Hypothyroxinemia
- Sponsor
- Centre Hospitalier Universitaire, Amiens
- Enrollment
- 50
- Locations
- 3
- Primary Endpoint
- Neurodevelopmental outcome
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
Transient hypothyroxinemia of prematurity (THOP) is associated with neurodevelopmental impairment in preterm newborns < 32 weeks of gestation (WG). It is not known whether L-Thyroxine supplementation for preterm newborns <32 WG with THOP is beneficial.
The purpose of this study is to compare L-thyroxine treatment vs. placebo in newborn less than 32 WG with THOP.
The primary endpoint is the neurodevelopmental outcome at two years of life, assessed by the Brunet-Lézine score. The secondary endpoints are: death, bronchopulmonary dysplasia (oxygen therapy at 28 days of life and at 36 weeks of postnatal age), patent ductus arteriosus, shock requiring fluid loading or vasoactive treatments, enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, deafness.
Detailed Description
Preterm newborns \<32 weeks of gestation (WG) are screened for THOP between day 5 and day 7 of life. THOP is defined by thyroid-stimulating hormone (TSH) \< 20 mIU/L and FT4 \< 0.80 ng/dL. After obtaining written consent from the parents, preterm newborns \<32 WG with THOP will be included. Randomization is stratified by center and 2 age-groups (24-28 WG and 29-32 WG). One arm will receive L-thyroxine treatment and the other arm will receive placebo. Treatment will be started within one week after diagnosis and will last 6 weeks. TSH and FT4 will be assayed 2 weeks after stopping treatment. The primary endpoint is the neurodevelopmental outcome at two years of life, assessed by the Brunet-Lézine score.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Gestational age \< 32 WG
- •FT4 (5, 6 or 7 days of life) ≤ 0.8 ng/dL
- •TSH (5, 6 or 7 days of life) \< 20 mIU/L
- •Written consent from the parents
Exclusion Criteria
- •Maternal thyroid disease
- •FT4 (5, 6 or 7 days of life) \> 0.8 ng/dL
- •TSH (5, 6 or 7 days of life) \> 20 mIU/L
- •Grade III or IV intracerebral hemorrhage
Arms & Interventions
water
Oral treatment with water for 6 weeks
Intervention: water
L-Thyroxine
Oral treatment with L-Thyroxine for 6 weeks
Intervention: L-Thyroxine
Outcomes
Primary Outcomes
Neurodevelopmental outcome
Time Frame: 2 years old
Brunet-Lézine score
Secondary Outcomes
- Morbidity associated with management of newborns < 32 WG with hypothyroxinemia(discharge, 1 year, 2 years)