Suggested protocol for thyroid screening in preterm infants (birth weight <1500 g or gestational age <32 weeks)

Protocol may vary depending on infant's gestational age and on whether the screening program uses T4 versus TSH as a primary screening test.

T4: thyroxine; TSH: thyroid-stimulating hormone.

* A low T4 and non-elevated (normal or low) TSH on the initial screen is a common finding in preterm babies when screened by the primary T4-reflex TSH method. Infants with this result on the initial screen do not require serum testing but should be screened again at 2 to 4 weeks of age.

¶ Most infants will have normal results on the second screen. Those with persistent low T4 require further evaluation with serum testing to evaluate for the possibility of primary or central hypothyroidism.

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Suggested protocol for thyroid screening in preterm infants (birth weight <1500 g or gestational age <32 weeks)