Comparative Study Of Thyroid Hormone Levels In Newborns With And Without Perinatal Asphyxia In Dr Sushila Tiwari Hospital

Abstract

Background: Perinatal asphyxia remains a leading cause of neonatal morbidity and mortality, particularly in low- and middle-income countries like India. While its neurological and systemic sequelae are well recognized, its endocrine effects—especially on the hypothalamic-pituitary-thyroid (HPT) axis—are less explored. Thyroid hormones are essential for early neurodevelopment, and hypoxia may impair their regulation, contributing to further neonatal complications.

Objectives: To compare thyroid hormone levels (T3, T4, TSH) between term neonates with and without perinatal asphyxia and to assess their association with hypoxic-ischemic encephalopathy (HIE) staging and neonatal outcomes in a tertiary care setting.

Methods: A cross-sectional, hospital-based study was conducted at Dr. Sushila Tiwari Hospital, Haldwani, including 130 term neonates—65 with perinatal asphyxia and 65 healthy controls. Blood samples were collected at 72 hours of life for thyroid hormone analysis. Clinical data including birth weight, mode of delivery, Apgar scores, and multi-organ function parameters were recorded. HIE was staged using Sarnat and Sarnat criteria. Statistical analysis was done using SPSS; p<0.05 was considered significant.

Results: Mean T3 and T4 levels were significantly lower, while TSH was markedly elevated in asphyxiated neonates (p<0.001). Thyroid dysfunction severity correlated with HIE stage and low birth weight. Multi-organ dysfunction and need for ventilatory support were significantly associated with altered thyroid status. Logistic regression identified low T3, severe HIE, and low maternal education as predictors of mortality.

Conclusion: Perinatal asphyxia significantly alters thyroid function, with prognostic implications. Routine screening for thyroid dysfunction may guide timely intervention.