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Adrenal and thyroid function in the fetus and preterm infant.
[congenital adrenal hyperplasia]
Adrenal
and
thyroid
hormones
are
essential
for
the
regulation
of
intrauterine
homeostasis
,
and
for
the
timely
differentiation
and
maturation
of
fetal
organs
.
These
hormones
play
complex
roles
during
fetal
life
,
and
are
believed
to
underlie
the
cellular
communication
that
coordinates
maternal
-
fetal
interactions
.
They
serve
to
modulate
the
functional
adaptation
for
extrauterine
life
during
the
perinatal
period
.
The
pathophysiology
of
systemic
vasopressor-resistant
hypotension
is
associated
with
low
levels
of
circulating
cortisol
,
a
result
of
immaturity
of
hypothalamic
-
pituitary
-
adrenal
axis
in
preterm
infants
under
stress
.
Over
the
past
few
decades
,
studies
in
preterm
infants
have
shown
abnormal
clinical
findings
that
suggest
adrenal
or
thyroid
dysfunction
,
yet
the
criteria
used
to
diagnose
adrenal
insufficiency
in
preterm
infants
continue
to
be
arbitrary
.
In
addition
,
although
hypothyroidism
is
frequently
observed
in
extremely
low
gestational
age
infants
,
the
benefits
of
thyroid
hormone
replacement
therapy
remain
controversial
.
Screening
methods
for
congenital
hypothyroidism
or
congenital
adrenal
hyperplasia
in
the
preterm
neonate
are
inconclusive
.
Thus
,
further
understanding
of
fetal
and
perinatal
adrenal
and
thyroid
function
will
provide
an
insight
into
the
management
of
adrenal
and
thyroid
function
in
the
preterm
infant
.
Diseases
Validation
Diseases presenting
"fetal life"
symptom
aromatase deficiency
congenital adrenal hyperplasia
congenital diaphragmatic hernia
congenital toxoplasmosis
harlequin ichthyosis
hirschsprung disease
kallmann syndrome
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