ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Pediatric Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1548086
Single-Centre Prospective Study on Thyroid Function Outcomes and Neurological Prognoses at 3 Years of Age in Children with Mild Neonatal Hyperthyrotropinaemia
Provisionally accepted
- Peking University First Hospital, Beijing, China
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Objective: To explore early management strategies for full-term neonates with TSH 5–10 mU/L and normal FT4. Methods: In this single-center longitudinal prospective study, 88 neonates diagnosed at 7–14 days were followed to age three. Results: 94.3% (83/88) had transient TSH elevation; 77 normalized within two months without treatment, while six received levothyroxine (3–5µg/kg/day). Five neonates (5.7%) exhibited persistent hyperthyrotropinemia and had significantly higher initial TSH. No hyperthyroidism was observed. Following up to 3 years old, only one child (1/81, 1.2%) exhibited development delay in personal-social development. Neonates with transient hyperthyrotropinaemia scored higher in problem-solving and personal–social domains than those with persistent hyperthyrotropinaemia. Neonatal FT4 at 7–14 days, timing of TSH normalization, and maternal early-pregnancy FT4 influenced the neurodevelopment of neonates. Infants of mothers with gestational diabetes scored lower in the personal–social domain. Conclusions: Persistent hyperthyrotropinemia occurs in 5.7 % of mild cases and is associated with higher initial TSH. Levothyroxine at 3–5 µg/kg/day is both adequate and safe. The majority of neonates got a normal neurodevelopment by age 3, and the subtle difference between transient and persistent hyperthyrotropinemia was impacted by both maternal and neonatal factors.
Keywords: neonates, Hyperthyrotropinaemia, Hypothyroidism, Levothyroxine, neurological prognoses
Received: 19 Dec 2024; Accepted: 03 Jun 2025.
Copyright: © 2025 Sun, Zhang, Zhang, Zhou, Tang, Liu and Hou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xin Lin Hou, Peking University First Hospital, Beijing, China
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