Open Access, Peer-reviewed
pISSN 2508-4887
eISSN 2508-4895
    Korean J Perinatol. 2015 Mar;26(1):46-52. Korean.
    Published online Mar 31, 2015.
    https://doi.org/10.14734/kjp.2015.26.1.46
    Copyright © 2015 The Korean Society of Perinatology
    Original Article

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

    Eui Kyung Choi, M.D.,1 Hyeon Seung Lee, M.D.,1 Eun Hee Lee, M.D.,2 Sae Yun Kim, M.D.,1 Byoung Kook Lee, M.D.,1 Young Hwa Jung, M.D.,1 Ju sun Heo, M.D.,1 Seung Han Shin, M.D.,1 Ee-Kyung Kim, M.D.,1 Han-Suk Kim, M.D.,1 and Jung-Hwan Choi, M.D.1
      • 1Department of Pediatrics, College of Medicine, Seoul National University, Seoul, Korea.
      • 2Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
    • Correspondence to: Seung Han Shin, M.D., Department of Pediatrics, College of Medicine, Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul 110-774, Korea. Tel: +82-2-2027-7230, Fax: +82-2-2072-0274, Email: revival421@gmail.com
    Received October 01, 2014; Revised October 13, 2014; Accepted October 21, 2014.

    This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    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.

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

    Figures

    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.

    Tables

    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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    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
    Metrics
    Share
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    Tables
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