Thyroid function tests and outcome in neonates with neonatal sepsis
¹Sana Fatima, ²Tanveer Ahmad Chaudhry, ³Saima Ahsan,⁴Abdul Hafeez Soomro, ⁵Amna Fayyaz, ⁶Mahnoor Ali
¹PGT Paeds, PAEC General Hospital, Islamabad
²Consultant Paediatrician, PAEC General Hospital, Islamabad
³Consultant Paediatrician, PAEC General Hospital, Islamabad
⁴Consultant Paediatrician, PAEC General Hospital, Islamabad
⁵PGT Paeds, PAEC General Hospital, Islamabad
⁶PGT Paeds, PAEC General Hospital, Islamabad
Vol 16-02, pp 120-127
Submission: 05 December 2025 | Acceptance: 29 December 2025 | Publication: 14 January 2026
ABSTRACT:
Background: Neonatal sepsis also was a significant contributor to morbidity and mortality in infants, and it commonly caused multisystemic involvement, including the effects on the thyroid functions. The thyroid hormone was significant in development in the neonate and metabolic control. Existing literature had indicated that a non-thyroidal illness syndrome or euthyroid sick syndrome had been triggered by sepsis and could affect clinical outcomes.
Objective: This study was based on the aim of assessing the thyroid functional test (TFT) abnormalities among neonates with neonatal sepsis and compare the results with clinical outcomes.
Methods: A descriptive study was carried out in the Pediatrics department of PAEC general Hospital, Islamabad, Pakistan, which lasted six months after getting the synopsis approved, between October 2024 and March 2025. Ninety neonates with diagnosed neonatal sepsis were recruited. Serum T3, T4 and serum TSH levels were used to evaluate thyroid functionality. The final results of these neonates such as recovery and mortality were documented and analyzed with regards to the TFT results.
Results: Of the 90 neonates with sepsis, 62 (68.9) had results indicating abnormal thyroid function test, whereas 28 (31.1) indicated normal thyroid profile. The abnormality most frequently found was low T3 and T4 with normal or slightly low TSH levels as characterized by the euthyroid sick syndrome. Among the 62 neonates with abnormal TFTs, 18 (29.0%) had poor outcome (death or prolonged hospital stay) but among neonates whose TFTs were normal only 3 (10.7) had poor outcomes. It was found that there was the statistically significant relationship between abnormal thyroid function and poor clinical outcomes (p<0.05).
Conclusion: The results implied that thyroid dysfunction, especially in an euthyroid sick syndrome manifestation, was common in the neonates with sepsis and showed significant adverse clinical outcomes associations. Evaluation of thyroid activity in septic neonates as a routine procedure would help to distinguish between the high risk and moderate risk groups and might help to advance the intensive care planning in neonates.
Keywords: Neonatal sepsis, Thyroid function tests, Euthyroid sick syndrome, Neonatal outcomes, Non-thyroidal illness.