The effects of topical iodine containing antiseptics on thyroidal status and early neurodevelopment of preterm infants

Abstract Objectives The goal of this study was to determine the quality of these disinfectants’ effects on thyroid function and neurological scores in premature newborns aged 28 to 36 gestational weeks (GW). Methods This cohort study was conducted from October 2020 to September 2021 among 28–36 GW preterm infants at the neonatal care unit of Jiangnan University Hospital. We divided this 12 month period into two consecutive 6 month periods. Composite iodine disinfectants and alcohol are used for skin and umbilical cord disinfection of preterm infants, respectively. Urinary iodine concentration (UIC), thyroid hormone levels, and neonatal behavioral and neurological assessment (NBNA) scores were determined in both groups. Results A total of 126 patients were included in the study, 65 in the iodine exposed group and 61 in the alcohol group. The second UIC and the incidence of serum T4≤5 μg/dL and TSH≥10 mIU/L in the iodine exposed group were significantly higher than those in the alcohol group (p<0.05). The first NBNA score was lower in the iodine exposed group than in the alcohol group (p<0.05). However, whether it has clinical significance remains to be explored. There was a linear relationship between the two NBNA scores (iodine exposure group, R2=0.344; alcohol group, R2=0.227). No sepsis or other adverse outcomes occurred in the two groups of preterm infants after disinfection with different disinfectants. Conclusions Iodine-containing disinfectants seem to have the potential to cause an increased rate of thyroid dysfunction and a decreased neurological score and should be evaluated in further studies.