Effect of perinatal asphyxia on thyroid stimulating hormone and thyroid hormone levels in a rural tertiary care center in Mandya district of Karnataka, India

Sunil Kumar P., Haricharan K. R., Venugopala K. L.


Background: Studies have shown a difference between serum concentrations of TSH, T4, T3 and FT4 in asphyxiated newborns than in normal newborns which suggesting abnormal thyroid function in asphyxia. We planned this study to assess and compare the effect of perinatal asphyxia on thyroid stimulating hormone and thyroid hormone levels.

Methods: This was a tertiary care teaching hospital based, prospective case control study conducted on normal full term and full term asphyxiated neonates delivered and admitted in the neonatal intensive care unit at Adichunchanagiri Institute of Medical Sciences, B. G. Nagara, Karnataka, India from December 2012 to May 2014.

Results: The means for thyroid hormones, in cord blood, were similar in both groups, except rT3are higher for non-asphyxiated new born as compared to asphyxiate ones. In newborns with 18-24 hours of life, lower levels of T4, T3, FT4, and TSH were observed in asphyxiated newborns, in which the basal levels (in cord blood) with exception of FT4, failed to increase.

Conclusions: Our study suggests that lower T4, free T4, and T3 levels are secondary to lower TSH levels in asphyxiated newborns; also, peripheral metabolism of T4 in asphyxiated infants can be altered due to low T3 and normal reverse T3 levels. 


Asphyxia, TSH, Thyroid hormone levels

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Kliegman RM, Behrman RE, Jenson HB, Stanton BF, (eds.) Nelson textbook of Pediatrics. 19th ed. Philadelphia: Saunders; 2012.

Fisher DA, Dussault JH, Sack J, Chopra IJ. Ontogenesis of hypothalamic-pituitary-thyroid function and metabolism in man, sheep and rat. Recent Prog Horm Res. 1977;33:59-116.

Klein AH, Oddie TH, Parslow M, Foley TP, Fisher DA. Developmental changes in pituitary-thyroid function in the human fetus and newborn. Early Hum Dev. 1982;6:321-30.

Erenberg A. The effect of perinatal factors on cord thyroxine concentration. Early Hum Dev. 1978;X2:283-9.

Byfield PGH, Bird D, Yepez R, Land IM, Himsworth RL. Reverse tri-iodothyronine, thyroid hormone, and thyrotrophin concentrations inplacental cord blood. Arch Dis Child. 1978;53:620-4.

Pereira DN, Procianoy RS. Effect of perinatal asphyxia on thyroid-stimulating hormone and thyroid hormone levels. Acta Paediatr. 2003;92(3):339-45.

Moshang T, Chance KH, Kaplan MM, Utiger RD, Takahashi O. Effects of hypoxia on thyroid function tests. J Pediatr. 1980;97:602-4.

Pereira DN, Procianoy RS. Effect of perinatal asphyxia on thyroid hormones. J Pediatr (Rio J). 2001;77(3):175-8.

Borges M, Lanes R, Moret LA, Balochi D, Gonzalez S. Effect of asphyxia on free thyroid hormone levels in full term newborns. Pediatr Res. 1985;19:1305-7.

Wilson DM, Hopper AO, McDougall JR, Bayer MF, Hintz RL, Stevenson DK, et al. Serum free thyroxine values in term, premature and sick infants. J Pediatr. 1982;101:113.

Franklin R, O’Grady C. Neonatal thyroid function: effects of non-thyroidalillness. J Pediatr. 1985;107:599-602.