FREQUENCY OF CONGENITAL HYPOTHYROIDISM IN NEONATES PRESENTING IN NEONATAL PERIOD
Main Article Content
Keywords
Congenital hypothyroidism, Newborn, Thyroide stimulating hormone and Gestational period
Abstract
Background: A disorder known as congenital hypothyroidism (CH) occurs when the thyroid gland is unable to produce enough thyroid hormones at birth. Thyroxine (T4) and triiodothyronine (T3) are the two main thyroid hormones, and they are essential for controlling growth, development, and metabolism throughout the body.
Aims: The main objective of the Guthrie test to detect congenital hypothyroidism in newborns as soon as feasible and immediate intervention and therapy are made possible by early detection, and this is essential to avert the negative consequences of untreated CH, including intellectual impairment and growth abnormalities.
Study design: It was a cross sectional study conducted in the Pediatrics Department Sheikh zayed Hospital Rahm yar khan. The duratin of this study was 18 months, from Jully 2022 to December 2023.
Methds: There were a total of 2640 participants in this study. 2640 healthy infants, both genders, with birth weights >2.5 kg after 78 hours of life till 28th day of life.
Results: The study population was consists of N=2640 newborns. Mothers’ age range was 20-37 years with a mean age of 28.5±5.0 years. A total of mothers 63% were 27-33 years of age. 51% were male, and 49% were female. Both genders were born at gestational ages of 37 to 42 weeks, with 3.5 kg being the average birth weight for 59% of them. Just 0.07% of the mothers of these babies had a history of hypothyroidism overall, and 0.45% of them had taken drugs to treat their hypothyroidism while pregnant. The Guthrie method was 100% effective in screening all newborn babies in hypothyroidism. Of the 2640 neonates, 2637 (99.98%) had normal TSH levels, and 3 (0.11%) had higher TSH levels. Congenital hypothyriodism (CH) was therefore present in 0.11% of cases. TSH levels were 6.2 ± 4 mIU/l on average. When the data was examined for any correlations between CH and the aforementioned characteristics, it was discovered that CH was statistically significantly correlated with both the mother's drug use and hypothyroidism during pregnancy, p<0.005.
Conclusion: The Guthrie method has made a substantial contribution to the global success of newborn screening programs by making it easier to identify and treat metabolic abnormalities such as congenital hypothyroidism early on. Further enhancements to the effectiveness of this crucial public health intervention will come from ongoing work to optimize screening techniques, increase awareness of the significance of early identification, and expand access to newborn screening.
Aims: The main objective of the Guthrie test to detect congenital hypothyroidism in newborns as soon as feasible and immediate intervention and therapy are made possible by early detection, and this is essential to avert the negative consequences of untreated CH, including intellectual impairment and growth abnormalities.
Study design: It was a cross sectional study conducted in the Pediatrics Department Sheikh zayed Hospital Rahm yar khan. The duratin of this study was 18 months, from Jully 2022 to December 2023.
Methds: There were a total of 2640 participants in this study. 2640 healthy infants, both genders, with birth weights >2.5 kg after 78 hours of life till 28th day of life.
Results: The study population was consists of N=2640 newborns. Mothers’ age range was 20-37 years with a mean age of 28.5±5.0 years. A total of mothers 63% were 27-33 years of age. 51% were male, and 49% were female. Both genders were born at gestational ages of 37 to 42 weeks, with 3.5 kg being the average birth weight for 59% of them. Just 0.07% of the mothers of these babies had a history of hypothyroidism overall, and 0.45% of them had taken drugs to treat their hypothyroidism while pregnant. The Guthrie method was 100% effective in screening all newborn babies in hypothyroidism. Of the 2640 neonates, 2637 (99.98%) had normal TSH levels, and 3 (0.11%) had higher TSH levels. Congenital hypothyriodism (CH) was therefore present in 0.11% of cases. TSH levels were 6.2 ± 4 mIU/l on average. When the data was examined for any correlations between CH and the aforementioned characteristics, it was discovered that CH was statistically significantly correlated with both the mother's drug use and hypothyroidism during pregnancy, p<0.005.
Conclusion: The Guthrie method has made a substantial contribution to the global success of newborn screening programs by making it easier to identify and treat metabolic abnormalities such as congenital hypothyroidism early on. Further enhancements to the effectiveness of this crucial public health intervention will come from ongoing work to optimize screening techniques, increase awareness of the significance of early identification, and expand access to newborn screening.
References
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17. Hashemipour, M., Samei, P., Kelishadi, R., Hovsepian, S., & Hani Tabaei Zavareh, N. (2019). A systematic review on the risk factors of congenital hypothyroidism. Journal of Pediatrics Review, 7(4), 199-210.
18. Kaluarachchi, D. C., Allen, D. B., Eickhoff, J. C., Dawe, S. J., & Baker, M. W. (2019). Increased congenital hypothyroidism detection in preterm infants with serial newborn screening. The Journal of Pediatrics, 207, 220-225.
19. McGrath, N., Hawkes, C. P., McDonnell, C. M., Cody, D., O’Connell, S. M., Mayne, P. D., & Murphy, N. P. (2018). Incidence of congenital hypothyroidism over 37 years in Ireland. Pediatrics, 142(4).
20. Bauer, A. J., & Wassner, A. J. (2019). Thyroid hormone therapy in congenital hypothyroidism and pediatric hypothyroidism. Endocrine, 66(1), 51-62.
21. Peters, C., & Schoenmakers, N. (2022). Mechanisms in endocrinology: the pathophysiology of transient congenital hypothyroidism. European Journal of Endocrinology, 187(2), R1-R16.
22. Pillai, N. S., & Bennett, J. (2018). Prevalence of hypothyroidism amongst pregnant women: a study done in rural set up. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 7(4), 1586-1592.
23. Sharma, D. V., & Shukla, D. N. (2019). Prevalence of hypothyroidism in pregnancy and its feto-maternal outcome. Obs Rev J Obstet Gynecol, 5(1), 7-12.
24. Mashabi, Y. (2024). Screening T4 and TSH in Early Detection of Congenital Hypothyroidism in Newborns: What’s the Dilemma?. Jurnal Biomedika dan Kesehatan, 7(1), 1-5.
25. Dorreh, F., Chehrei, A., Rafiei, F., Talaei, A., Rezvanfar, M., & Almasi-Hashiani, A. (2020). Determining the TSH reference range in national newborn screening program for congenital hypothyroidism. The Journal of Maternal-Fetal & Neonatal Medicine, 33(19), 3244-3248.
2. Rose, S. R., Wassner, A. J., Wintergerst, K. A., Yayah-Jones, N. H., Hopkin, R. J., Chuang, J., ... & SECTION ON ENDOCRINOLOGY EXECUTIVE COMMITTEE Wintergerst Kupper A. MD, FAAP Bethin Kathleen E. MD, FAAP Brodsky Jill L. MD, FAAP Jelley David H. MD, FAAP Marshall Bess A. MD, FAAP Mastrandrea Lucy D. MD, PhD, FAAP Lynch Jane L. MD, FAAP Laskosz Laura MPH. (2023). Congenital hypothyroidism: screening and management. Pediatrics, 151(1), e2022060420.
3. Stoupa, A., Kariyawasam, D., Muzza, M., de Filippis, T., Fugazzola, L., Polak, M., ... & Carré, A. (2021). New genetics in congenital hypothyroidism. Endocrine, 71, 696-705.
4. Kostopoulou, E., Miliordos, K., & Spiliotis, B. (2021). Genetics of primary congenital hypothyroidism—a review. Hormones, 20, 225-236.
5. Stoupa, A., Kariyawasam, D., Polak, M., & Carré, A. (2022). Genetics of congenital hypothyroidism: Modern concepts. Pediatric Investigation, 6(02), 123-134.
6. Zhang, J., & Li, Y. (2021). Risk factors for neonatal congenital hypothyroidism: a Meta analysis. Zhongguo Dang dai er ke za zhi= Chinese Journal of Contemporary Pediatrics, 23(5), 505-512.
7. Tuli, G., Munarin, J., Tessaris, D., Matarazzo, P., Einaudi, S., & de Sanctis, L. (2021). Incidence of primary congenital hypothyroidism and relationship between diagnostic categories and associated malformations. Endocrine, 71, 122-129.
8. Peters, C., & Schoenmakers, N. (2022). Mechanisms in endocrinology: the pathophysiology of transient congenital hypothyroidism. European Journal of Endocrinology, 187(2), R1-R16.
9. Mengreli, C., Kanaka-Gantenbein, C., Girginoudis, P., Magiakou, M. A., Christakopoulou, I., Giannoulia-Karantana, A., ... & Dacou-Voutetakis, C. (2010). Screening for congenital hypothyroidism: the significance of threshold limit in false-negative results. The Journal of Clinical Endocrinology & Metabolism, 95(9), 4283-4290.
10. Kağızmanlı, G. A., & Demir, K. (2023). Interpretation, differential diagnosis, and clinical implications of abnormal thyroid function tests in children. Trends in Pediatrics, 4(2), 61-71.
11. Costeira, M. J., Martins, A., Reis, R., Vilarinho, L., & Palha, J. (2021). Neonatal Screening Program of Congenital Hypothyroidism: How Can We (Still) Improve?.
12. Ettleson, M. D., & Bianco, A. C. (2020). Individualized therapy for hypothyroidism: is T4 enough for everyone?. The Journal of Clinical Endocrinology & Metabolism, 105(9), e3090-e3104.
13. Scavone, M., Giancotti, L., Anastasio, E., Pensabene, L., Sestito, S., & Concolino, D. (2020). Evolution of congenital hypothyroidism in a cohort of preterm born children. Pediatrics & Neonatology, 61(6), 629-636.
14. Kopel, J. (2020, January). A global perspective on newborn congenital hypothyroidism screening. In Baylor University Medical Center Proceedings (Vol. 33, No. 1, pp. 137-139). Taylor & Francis.
15. Minamitani, K. (2021). Newborn screening for congenital hypothyroidism in Japan. International Journal of Neonatal Screening, 7(3), 34.
16. Peters, C., Van Trotsenburg, A. S. P., & Schoenmakers, N. (2018). Diagnosis of endocrine disease: congenital hypothyroidism: update and perspectives. European journal of endocrinology, 179(6), R297-R317.
17. Hashemipour, M., Samei, P., Kelishadi, R., Hovsepian, S., & Hani Tabaei Zavareh, N. (2019). A systematic review on the risk factors of congenital hypothyroidism. Journal of Pediatrics Review, 7(4), 199-210.
18. Kaluarachchi, D. C., Allen, D. B., Eickhoff, J. C., Dawe, S. J., & Baker, M. W. (2019). Increased congenital hypothyroidism detection in preterm infants with serial newborn screening. The Journal of Pediatrics, 207, 220-225.
19. McGrath, N., Hawkes, C. P., McDonnell, C. M., Cody, D., O’Connell, S. M., Mayne, P. D., & Murphy, N. P. (2018). Incidence of congenital hypothyroidism over 37 years in Ireland. Pediatrics, 142(4).
20. Bauer, A. J., & Wassner, A. J. (2019). Thyroid hormone therapy in congenital hypothyroidism and pediatric hypothyroidism. Endocrine, 66(1), 51-62.
21. Peters, C., & Schoenmakers, N. (2022). Mechanisms in endocrinology: the pathophysiology of transient congenital hypothyroidism. European Journal of Endocrinology, 187(2), R1-R16.
22. Pillai, N. S., & Bennett, J. (2018). Prevalence of hypothyroidism amongst pregnant women: a study done in rural set up. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 7(4), 1586-1592.
23. Sharma, D. V., & Shukla, D. N. (2019). Prevalence of hypothyroidism in pregnancy and its feto-maternal outcome. Obs Rev J Obstet Gynecol, 5(1), 7-12.
24. Mashabi, Y. (2024). Screening T4 and TSH in Early Detection of Congenital Hypothyroidism in Newborns: What’s the Dilemma?. Jurnal Biomedika dan Kesehatan, 7(1), 1-5.
25. Dorreh, F., Chehrei, A., Rafiei, F., Talaei, A., Rezvanfar, M., & Almasi-Hashiani, A. (2020). Determining the TSH reference range in national newborn screening program for congenital hypothyroidism. The Journal of Maternal-Fetal & Neonatal Medicine, 33(19), 3244-3248.
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Published
Dec 11, 2024
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How to Cite
Dr. Raghib Iqbal, Dr. Zahid Mehmood, Dr. Kifayat-Ullaha Khan, Dr. Shaista Haider, Dr. Ayesha Tahira, & Dr. Sajida Khalid. (2024). FREQUENCY OF CONGENITAL HYPOTHYROIDISM IN NEONATES PRESENTING IN NEONATAL PERIOD. Journal of Population Therapeutics and Clinical Pharmacology, 31(11), 2058-2065. https://doi.org/10.53555/yxxy1z56
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Author Biographies
Dr. Raghib Iqbal
Assistant Professor, Department of Pediatric Medicine, Sheikh Zayed Medical College/ Hospital, Rahim Yar Khan, Pakistan
Dr. Zahid Mehmood
Senior Registrar, Department of Pediatric Medicine, Sheikh Zayed Medical College/ Hospital, Rahim Yar Khan, Pakistan
Dr. Kifayat-Ullaha Khan
Senior Registrar, Pediatric Medicine, Sheikh Zayed Medical college/ Hospital, Rahim Yar Khan, Pakistan
Dr. Shaista Haider
Senior Registrar, Pediatric Medicine, Sheikh Zayed Medical college/ Hospital, Rahim Yar Khan, Pakistan
Dr. Ayesha Tahira
Woman Medical Officer, Department of Pediatric Medicine, Sheikh Zayed Medical College/ Hospital, Rahim Yar Khan, Pakistan
Dr. Sajida Khalid
Senior Registrar, Pediatric Medicine, Sheikh Zayed Medical college/ Hospital, Rahim Yar Khan, Pakistan
How to Cite
Dr. Raghib Iqbal, Dr. Zahid Mehmood, Dr. Kifayat-Ullaha Khan, Dr. Shaista Haider, Dr. Ayesha Tahira, & Dr. Sajida Khalid. (2024). FREQUENCY OF CONGENITAL HYPOTHYROIDISM IN NEONATES PRESENTING IN NEONATAL PERIOD. Journal of Population Therapeutics and Clinical Pharmacology, 31(11), 2058-2065. https://doi.org/10.53555/yxxy1z56