Congenital hypothyroidism screening with umbilical cord blood thyroid-stimulating hormone at birth and peripheral venous blood thyroid-stimulating hormone after 72 h at a hospital in suburban area of Chhattisgarh

Abstract

Background: Primary congenital hypothyroidism (CH) is the most common cause of hypothyroidism in infancy and early childhood. Neonatal screening programs for the detection of CH in the neonatal period are widespread and in most screening programs, blood samples are collected at 5–6 days age. Objective: The objective of the study was to obtain cord blood (CB) samples at birth and the peripheral venous blood sample of thyroid-stimulating hormone (TSH) at 72 h. Materials and Methods: This cross-sectional observational study was done at a tertiary suburban center and a total of 1470 newborn delivered was enrolled after satisfying the inclusion criteria. Umbilical CB TSH sample was taken at birth and peripheral venous sample for TSH was taken at 72 h. TSH values more than 20 ?IU/mL, in both groups, were taken as an upper limit of normal. Results: Out of 1470 samples collected, among those with umbilical cord sample, 31 (2%) had a value >20 ?IU/mL, while only one baby had a value of TSH >20 ?IU/mL at 72 h of life and was diagnosed as CH. Conclusion: The incidence of CH is 1 out of 1470 neonates. Female gender, maternal age, and lower socioeconomic status of parents have a significant impact on umbilical cord TSH Levels.

Congenital hypothyroidism in India: A systematic review and meta-analysis of prevalence, screen positivity rates, and etiology

“…Seventy-nine studies were included in the systematic review, and 70 studies in the meta-analysis. 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 The flow...…”

“…The prevalence of CH was estimated separately for neonates in endemic and non-endemic regions, neonates born to mothers with thyroid disease and preterm neonates. Meta-analysis of 54 studies that included term neonates from non-endemic regions (55 datasets, and 819 559 neonates) 11 , 12 , 13 , 14 , 17 , 19 , 20 , 21 , 22 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 55 , 56 , 57 , 62 , 63 , 64 , 65 , 67 , 68 , 69 , 71 , 72 , 73 , 74 , 75 , 76 , 80 gave a pooled prevalence of 0·97 per 1 000 neonates (95% confidence interval/CI: 0·9 to 1·04), which is about 1 in 1 031 neonates. The I 2 statistic was 92%, while the variance in pooled estimates was narrow.…”

“…Studies included in this meta-analysis reported varying screen positivity cut-offs for cord TSH (10–40 mIU/l) and postnatal TSH (6–20 mIU/L). On meta-analysis of 23 studies (35 069 neonates) 16 , 17 , 19 , 27 , 28 , 29 , 37 , 40 , 44 , 45 , 47 , 48 , 57 , 59 , 63 , 66 , 67 , 68 , 72 , 75 , 77 , 78 , 80 that used a cord TSH cut-off of 20 mIU/L for screen positivity, the pooled estimate of screen positivity rate was 5·6% (95% CI: 5·4% to 5·9%). The forest plot is shown in Figure 2 e. The funnel plot was asymmetric (Figure S2) indicating the presence of publication bias.…”

“…Twenty-eight studies (515 975 neonates) 16 , 17 , 19 , 20 , 21 , 24 , 25 , 26 , 27 , 28 , 29 , 35 , 38 , 40 , 41 , 46 , 47 , 48 , 55 , 57 , 64 , 67 , 68 , 73 , 74 , 75 , 76 , 80 provided data on compliance with confirmatory testing for screen positive neonates ( Figure 2 g). Except one study from endemic region, 16 the rest were from non-endemic regions.…”

“…Among these 28 studies, 17 studies used cord TSH 16 , 17 , 19 , 27 , 28 , 29 , 40 , 41 , 47 , 48 , 57 , 64 , 67 , 68 , 75 , 76 , 80 and 11 studies used postnatal TSH 20 , 21 , 24 , 25 , 26 , 35 , 38 , 46 , 55 , 73 , 74 for screening. The compliance for confirmatory testing for studies using cord TSH and postnatal TSH were 79% (95% CI: 78%, 80%) and 58% (95% CI: 56%, 59%), respectively (Table S9).…”