TY  - JOUR
T1  - Non-Thyroidal Illness Syndrome in Neonatal Intensive Care Units
TT  - Yenidoğan Yoğun Bakım Ünitesinde Tiroid Dışı Hastalık Sendromu
AU  - Boydağ Güvenç, Kübra
AU  - Çakır, Esra Papatya
AU  - Salihoğlu, Özgül
PY  - 2025
DA  - June
Y2  - 2025
DO  - 10.26453/otjhs.1633458
JF  - Online Turkish Journal of Health Sciences
JO  - OTSBD
PB  - Oğuz KARABAY
WT  - DergiPark
SN  - 2459-1467
SP  - 124
EP  - 130
VL  - 10
IS  - 2
LA  - en
AB  - Objective: This study aims to establish the incidence of non-thyroidal illness syndrome (NTIS) in newborns and investigate its potential impact on neonatal outcomes. Additionally, by identifying the risk factors associated with the development of NTIS, this study aims to deepen the understanding of the condition.Materials and Methods: A total of 337 patients in the neonatal intensive care unit were studied retrospectively. Data on demographic and clinical characteristics, including gestational age, birth weight, head circumference, height, Apgar score, SNAPPE score, presence of congenital anomalies, mode of delivery, respiratory support, and duration of hospitalization, were collected. All patients underwent measurement of TSH and free T4 levels.Results: The study found that 4.5% of patients were diagnosed with NTIS. Patients with NTIS had higher rates of preterm delivery. NTIS patients exhibited lower gestational age, birth weight, head circumference, height, and Apgar scores than non-NTIS patients. NTIS patients had significantly more extended hospital stays, but no differences in mechanical ventilation duration or SNAPPE scores were obtained.Conclusions: This study indicates that thyroid dysfunction can occur in critically ill newborns, highlighting the necessity of evaluating thyroid function in this demographic.
KW  - Euthyroid sick syndrome
KW  - neonatal intensive care unit
KW  - non-thyroidal illness syndrome
KW  - thyroid function tests
KW  - thyroid screening
N2  - Amaç: Bu çalışmanın amacı yenidoğanlarda tiroid dışı hastalık sendromunun (TDHS) yaygınlığını belirlemek ve yenidoğan sonuçları üzerindeki potansiyel etkilerini araştırmaktır. Ayrıca, TDHS gelişimi ile ilişkili risk faktörlerini belirleyerek, sendromun daha iyi anlaşılmasına katkıda bulunmak amaçlanmaktadır.Materyal ve Metot: Yenidoğan yoğun bakım ünitesinde yatan 337 hastanın verileri retrospektif olarak toplandı. Gebelik yaşı, doğum ağırlığı, Apgar skoru, SNAPPE skoru, doğum şekli, konjenital anomaliler, solunum desteği ve hastanede yatış süresi gibi demografik ve klinik veriler toplanmıştır. Tüm hastalarda tiroid uyarıcı hormon (TSH) ve serbest tiroksin (sT4) düzeyleri ölçülmüştür.Bulgular: Çalışmaya alınan hastaların %4,5’inde TDHS saptanmıştır. TDHS tanısı alan hastalar, daha düşük gebelik haftası, doğum ağırlığı, baş çevresi, boy, ve Apgar skorlarına sahipti. TDHS hastalarının hastane yatış süreleri anlamlı şekilde daha uzun bulunmuş,  ancak mekanik ventilasyon süresi  ve  SNAPPE  skorlarında  fark gözlenmemiştir.Sonuç: Bu çalışma, kritik hastalık geçiren yenidoğanlarda tiroid fonksiyon bozukluklarının görülebileceğini ve bu grubun tiroid fonksiyonlarının değerlendirilmesinin önemli olduğunu göstermektedir.
CR  - Perlman JM. Neuro behavioral deficits in prematüre graduates of intensive care-potential medical and neonatal environmental risk factors. Pediatrics. 2001;108(6):1339-1348. doi:10.1542/peds.108.6.1339
CR  - Gressens P, Rogido M, Paindaveine B, Sola A. The impact of neonatal intensive care practices on the developing brain. J Pediatr. 2002;140(6):646-653. doi:10.1067/mpd.2002.123214
CR  - Kerr DE, Wenham T, Newell-Price J. Endocrine problems in the critically ill 2: endocrine emergencies. BJA Educ.  2017;17(11):377-382. doi:10.1093/bjaed/mkx023
CR  - La Franchi SH. Thyroid function in preterm/lowbirth weight infants: Impact on diagnosis and management of thyroid dysfunction. Front Endocrinol (Lausanne). 2021;12:666207. doi:10.3389/fendo.2021.666207
CR  - Golombek SG. Nonthyroidal illness syndrome and euthyroid sick syndrome in intensive care patients. Semin Perinatol.  2008;32(6):413-418.  doi:10.1053/j.semperi.2008.09.010
CR  - Docter R, Krenning EP, De Jong M, Hennemann G. The sick euthyroid syndrome: changes in thyroid hormone serum parameters and hormone metabolism. Clin Endocrinol (Oxf). 1993;39(5):499-518. doi:10.1111/j.1365-2265.1993.tb02401.x
CR  - Krug N, Bercker S, Busch T, Friese S, Jahn N, Voelker MT. Non-thyroidal illness syndrome (NTIS) is no independent predictor for mortality in ICU patients. BMC Anesthesiol. 2023;23(1):103. doi:10.1186/s12871-023-02015-1
CR  - deVries EM, Fliers E, Boelen A. The molecular basis of the non-thyroidal illness syndrome.  J Endocrinol.  2015;225(3):R67-R81.  doi:10.1530/joe-15-0133
CR  - Goldsmit GS, Valdes M, Herzovich V, et al. Evaluation and clinical application of changes in thyroid hormone and TSH levels in critically ill full-term newborns. J Perinat Med.  2011;39(1):59-64. doi:10.1515/jpm.2010.120
CR  - Shampo MA, Kyle RA. Virginia Apgar--the Apgar score. Mayo Clin Proc. 1995;70(7):680. doi:10.4065/70.7.680
CR  - Richardson DK, Corcoran JD, Escobar GJ, Lee SK. SNAP-II and SNAPPE-II: Simplified newborn illness severity and mortality risk scores. J Pediatr. 2001;138(1):92-100. doi:10.1067/mpd.2001.109608
CR  - Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R. New Ballard score, expandedo include extremely prematüre infants. J Pediatr. 1991;119(3):417-423. doi:10.1016/S0022-3476(05)82056-6
CR  - Demir K, Besci T, Besci Ö, et al. Biochemical indicators of euthyroid sick syndrome in critically ill children. J Pediatr Endocrinol Metab. 2022;35(10):1285-1292. doi:10.1515/jpem-2022-0232
CR  - Guo J, Hong Y, Wang Z, Li Y. Analysis of the incidence of euthyroid sick syndrome in comprehensive intensive care units and related risk factors. Front Endocrinol (Lausanne). 2021;12.  doi:10.3389/fendo.2021.656641
CR  - Hemmati F, Pishva N. Evaluation of thyroid status of infants in the intensive care setting. Singapore Medical Journal. 2009;50(9):875-878.
CR  - Rai R, Singh DK, Bhakhri BK. Hypothyroxinemia in sick term neonates and its risk factors in an extramural neonatal intensive care unit: a prospective cohort study. Arch Endocrinol Metab.  2022;66(4):466-471. doi:10.20945/2359-3997000000500
CR  - Zibitt M, Ange B, Wynter Z, Mundy C, Herrmann S, Stansfield BK. Hypothyroxinemia and weight velocity in preterm infants. J Pediatr Endocrinol Metab. 2024;37(3):236-242. doi:10.1515/JPEM-2023-049
CR  - Zdraveska N, Kocova M. Thyroid function and dysfunction in preterm infants—Challenges in evaluation, diagnosis and therapy. Clin Endocrinol (Oxf). 2021;95(4):556-570. doi:10.1111/cen.14481
CR  - Steinke TJ, O’Callahan EL, York JL. Transient hypothyroidism in the newborn: to treat or not to treat. Transl Pediatr.  2017;6(4):34958-34358. doi:10.21037/tp.2017.09.05
CR  - Aygün E, Semerci SY, Sağlık AÇ, Ertürk EY. Neuro developmental outcome of infants with transient hypothyroxinemia of prematurity in a newborn intensive care unit. J Clin Res Pediatr Endocrinol.  2024;16(1):60-68. doi:10.4274/jcrpe.galenos.2023.2023-6-5
CR  - Stawerska R, Nowak-Bednarek M, Talar T, et al. The prevalence of hypothyroxinemia in premature newborns. Front Endocrinol (Lausanne). 2022;13. doi:10.3389/fendo.2022.940152
CR  - Yoon SA, Chang YS, Ahn SY, Sung SI, Park WS. Incidence and severity of transient hypothyroxinaemia of prematurity associated with survival without composite morbidities in extremely low birth weight infants. Sci Rep. 2019;9(1):9628. doi:10.1038/s41598-019-46108-9
CR  - Improda N, Capalbo D, Poloniato A, et al. Perinatal asphyxia and hypothermic treatment from the endocrine perspective. Front Endocrinol (Lausanne). 2023;14. doi:10.3389/fendo.2023.1249700
CR  - Ahmad Fikri ZA, Ramli N, Ibrahim NR, Van Rostenberghe HA, Cheng KY. Effect of birth asphyxia on the thyroid hormone in term newborns delivered in Hospital Universiti Sains Malaysia (Hospital USM). Malaysian J Med Health Sci. 2024;20(supp3):47-51. doi:10.47836/mjmhs20.s3.7
CR  - Pereira D, Procianoy RS. Effect of perinatal asphyxia on thyroid-stimulating hormone and thyroid hormone levels.  Acta Paediatr. 2007;92(3):339-345. doi:10.1111/j.1651-2227.2003.tb00556.x
CR  - El-Nawawy A, Elwafa RAHA, Khalil Abouahmed A, Rasheed RA, Omar OM. Evaluation of non-thyroidal illness syndrome in shock patients admitted to pediatric intensive care unit in a developing country. Eur J Pediatr. 2024;183(2):769-778. doi:10.1007/s00431-023-05338-w
CR  - Xu MX, Liu G, Cao LJ, et al. Association of non-thyroidal illness syndrome with interleukin-6 and interleukin-10 in critically ill children with sepsis.  Zhongguo Dang Dai Er Ke Za Zhi. 2020;22(11):1215-1220. doi:10.7499/j.issn.1008-8830.2004137
UR  - https://doi.org/10.26453/otjhs.1633458
L1  - https://dergipark.org.tr/tr/download/article-file/4580839
ER  -