Abstract:
Many transient endocrinologic disorders are frequently seen in newborn period. Early diagnosis and treatment is important for babies. Here we review the transient endocrinopathy of newborn. Blood sugar problems, especially adrenal insufficiency due to adrenal problems, thyroid problems such as transient hypotirotropinemia, are frequently encountered by physicians. Genital and urinary problems should be evaluated differently according to gender. Problems related to calcium metabolism, problems associated with water metabolism and endocrine skin problems are other problems.
The physiology and regulation of bone minerals in the fetus and the newborn is significantly different from children and adults. The bone minerals calcium, phosphate and magnesium are all maintained at higher concentrations in utero to achieve adequate bone accretion. This is an integral component of normal fetal development which facilitates safe neonatal transition to post-natal life. When deciphering the cause of bone mineral disorders in newborns, the potential differential diagnosis list is broad and complex, including several extremely rare conditions. Also, significant discoveries including new embryological molecular genetic transcription factors, the role of active placental mineral transport, and hormone regulation factors have changed the understanding of calcium and phosphate homeostasis in the fetus and the newborn. Endocrine disorders develop commonly in preterm neonates and critically ill neonates. Preterm newborns have immature endocrine system as well as immature organs. Their adaptation to extrauterine life might be more challenging and more unfavorable. The most common endocrine disorders in the sick and preterm newborn are thyroid disorders, hypocalcemia, adrenal insufficiency and disorders of glucose metabolism. To detect the endocrine problems appropriately and to find best approaches to them, pediatric neonatologists and endocrinologists should be well aware of the epidemiology, pathophysiology, clinical characteristics and effective management of common endocrine disorders in the sick and preterm newborns. The thyroid axis is a prime example of the physiologic interactions between the mother, the fetus, and their environment. Congenital hypothyroidism is one of the most common preventable causes of mental retardation. The discovery of the crucial role of maternal iodine intake for the normal development of the fetus also led to the first successful intervention in preventive medicine. The use of iodized salt at the population level resulted in a marked decrease in the prevalence of goiter in children and the disappearance of “endemic cretinism” in the industrialized world. The newborn screening program for congenital hypothyroidism is hailed as an unqualified success. At present, most severe cases of congenital hypothyroidism are caused by developmental defects of the thyroid and, albeit much less frequently, to defective pituitary control of thyroid function.It is essential to know the normals of the hormones in the neonatal period in order to recognize them properly, to evaluate them properly and to interpret the tests correctly.
Audience Take Away
- This abstract will guide clinicians through an updated review of calcium and phosphate physiology, then review specific conditions pertinent to successful neonatal care
- Furthermore, with the advancement of increasingly rapid molecular genetic testing, genomics will continue to play a greater role in this area of fetal diagnostics and prognostication
- To detect the endocrine problems appropriately and to find best approaches to them, pediatric neonatologists and endocrinologists should be well aware of the epidemiology, pathophysiology, clinical characteristics and effective management of common endocrine disorders in the sick and preterm newborns
